Pneumococcal diseases are caused by a common but potentially harmful bacteria, Streptococcus pneumoniae. S. pneumoniae is the most common cause of pneumonia in the world and the most common cause of acute otitis media in children. There are 84 different pneumococcal serotypes. Some serotypes are common in adults, others are more common in children, and several are resistant to penicillin.
Disease Facts
Pneumococci are commonly found in the upper respiratory tract but generally, people have a high resistance to disease. Resistance may be lowered by a number of risk factors including: age extremes (very young and the very old); some viral upper respiratory tract infections, especially influenza; immunoglobulin deficiency; Hodgkin's disease; splenic dysfunction (including sickle-cell anemia); asplenia; chronic cardiovascular or pulmonary disease; diabetes; alcoholism; cirrhosis; kidney disease; recent organ transplantation; AIDS; smoking; living in crowded conditions (institutions, barracks and ships). Pneumococcal pneumonia occurs most often during the coldest months of the year when respiratory infections are common.
The bacteria can be spread from person to person through respiratory droplet spread or indirectly through contact with articles soiled with respiratory discharges.
Symptoms of pneumonia caused by S. pneumoniae are: a sudden onset of chills, fever, chest pain, difficulty breathing, and a cough producing "rusty" sputum. In the elderly, symptoms may be more subtle; a chest x-ray may provide the first evidence of pneumonia. In infants, vomiting and convulsions may be the first indication of infection.
S. pneumoniae is the third leading cause of bacterial meningitis in the United States, most cases are in children under 5 years of age. Meningitis can develop from untreated middle ear or sinus infections, pneumonia or bacteremia. Bacterial meningitis is seen as an acute onset of high fever, headache, vomiting, drowsiness and stiff neck. Illness progresses rapidly causing loss of consciousness and possibly death.
Symptoms may appear in 1-3 days from infection. People with normal immune systems may develop antibodies specific to each serotype of pneumococci which, in general, persist for life.
Clinical observation of the symptoms accompanied by laboratory cultures from blood and other body fluids and a high white blood cell count in people with normal immune systems. Chest x-rays are important diagnostic tools when pneumonia is suspected.
Penicillin is the drug of choice. Some serotypes are resistant to penicillin or, if the patient is allergic to penicillin, vancomycin, erythromycin, clindamycin and a number of other drugs are effective.
Good personal hygiene, such as covering the mouth when coughing or sneezing, sanitary disposal of discharges from the mouth and nose, and frequent hand-washing will help prevent transmission.
There is a vaccine available which is recommended for patients with underlying conditions that increase their susceptibility to pneumococcal infection or with increased risk of mortality. Pneumococcal vaccine is recommended for: healthy adults 65 or older, those with chronic cardiac, liver, or pulmonary disease, asplenia, alcoholism, diabetes, renal failure, Hodgkin's disease, leukemia, AIDS, chemotherapy or organ transplants.