Pneumococcal Pneumonia

The term “pneumonia” refers to any infection of the lungs. Pneumonia can be caused by a variety of viruses, bacteria, and sometimes fungi. Pneumococcal pneumonia is caused by bacteria called Streptococcus pneumoniae (pneumococcus). Pneumococcal pneumonia infects the upper respiratory tract and can spread to the blood, lungs, middle ear, or nervous system.

Previously healthy people can develop pneumococcal pneumonia, but the risk for acquiring the disease is highest among children younger than 2 years old and adults aged 64 years or older.

Susceptibility is also increased among certain populations including:  cigarette smokers; persons with underlying illnesses, such as anatomical or functional asplenia (loss of the spleen), sickle cell disease, cardiovascular disease, diabetes, cirrhosis, Hodgkin’s disease, alcoholism, lymphoma, multiple myeloma, chronic renal failure, nephritic syndrome, HIV infection, and recent organ transplants.  Malnutrition and low birth weight are important risk factors among infants and young children in developing countries.

Pneumococcal pneumonia usually begins abruptly, although the onset may be less sudden in elderly patients. The first signs of pneumonia in the elderly may be altered mental status, fever, and shortness of breath. General symptoms include:  initial severe shaking chills; high fever; fatigue; cough; shortness of breath; rapid breathing; chest pain; production of purulent (containing pus) or blood-tinged sputum; nausea; vomiting; headache.

Complications of pneumococcal pneumonia can include:  pneumococcal meningitis (inflammation of the linings of the brain), which presents with a stiff neck, headache, lethargy, or seizures; otitis media or sinusitis (inflammation of the ear and sinuses, respectively), both causing pain in the ears or sinuses; bacteremia (the bacteria invade the bloodstream from the lungs, causing further lung problems and certain heart problems); death, particularly in infants and the elderly.

Death rates vary widely. In developing countries,10 percent of children may die.  Among infants under the age of 6 months, the death rate can be as high as 60 percent.

Pneumococcal infections are usually treated with antibiotics, and the symptoms will usually disappear within 12 to 36 hours after you begin taking the medication.

Many strains of S. pneumoniae are becoming resistant to penicillin, cephalosporin, macrolides, and other drugs, complicating treatment choices. Antibiotic resistance is increasing worldwide due to these medicines being overused or misused.

Pneumococcal pneumonia occurs worldwide in all climates and seasons but peaks in winter in temperate zones. The disease occurs more commonly in developing countries, in certain geographic areas (Papua New Guinea), and in certain ethnic groups such as Alaskan natives and Australian aboriginals. Infection is more frequent among malnourished populations and lower socioeconomic groups.