Avoidance of false-negative blood culture results by rapid detection of pneumococcal antigen

False-negative blood culture results may occur in children with pneumococcal bacteremia due to bacterial autolysis. We describe four patients with pneumococcal bacteremia whose aerobic blood cultures showed partial or complete autolysis of the pneumococci. Pneumococcal antigen, however, was rapidly detected in media from the blood culture bottles, using an agglutination assay. Processing of the media before analysis was necessary to prevent nonspecific agglutination and to allow the detection of a specific reaction. It is important that physicians and laboratory personnel be aware that pneumococci may rapidly autolyze during incubation, yielding false-negative culture results. Antigen detection methods may provide rapid and specific identification of the etiologic agent.