Pneumococcal infections

What is pneumococcus and what diseases does it cause?

Streptococcus pneumoniae, or pneumococcus, is a bacterium that is considered the most common cause of pneumonia and a very important cause of meningitis, and inflammation of the middle ear and sinuses. In the first two years of life, a third of children get at least one such ear infection. Pneumococcal diseases usually begin abruptly, accompanied by high fever and shivering with general symptoms and signs indicating involvement of a particular organ.

Who gets sick most often?

The most endangered are the extreme age groups – infants and young children up to 2 years of age (the immune system is not yet fully developed) and people older than 65 (the immune system is weak). People with a weakened or damaged immune system (various chronic diseases, smokers, patients diagnosed with chronic bronchitis, those with a viral infection of the respiratory system, etc.) are more likely to suffer from diseases caused by pneumococcus. It is important to emphasize the role of the spleen – the site of decomposition of pneumococci that enter the bloodstream. Therefore, it is logical that the endangered group also includes those without a spleen or with its impaired function, and children with sickle cell anemia. Men get sick a bit more often than women (3: 2).

When do they occur?

Pneumococcal infections most commonly occur in winter and early spring (November to April). The reason for this is that then the most common viral respiratory infections (colds, flu) that create a good “fertile ground”, or a prerequisite for subsequent bacterial pneumococcal infection.

How does a person become infected?

Patients become infected by droplets, after prolonged and close contact, mainly due to their stay in closed, heated and insufficiently ventilated rooms. However, the finding of a bacterium does not necessarily mean a disease, it can also be a normal resident of the nasal mucosa and / or oral cavity.

What are the symptoms of pneumococcal pneumonia?

Incubation of the disease is usually from 1 to 3 days. The two leading symptoms are fever and productive cough with general symptoms — impotence, headache, muscle aches, nausea, vomiting, diarrhea, confusion. In young and previously healthy individuals, the onset of the disease is sudden and turbulent, although pneumonia is often preceded by viral inflammation of the upper respiratory tract. The temperature rises sharply, reaching up to 40 oC, and is usually accompanied by fever. In the elderly, symptoms appear gradually, temperatures are low (37.1-37.9 oC), cough and expectoration may be absent, and due to hypoxia (reduced oxygen supply to the tissues), confusion and disorientation may occur. In people without or with impaired spleen function, the most turbulent course of the disease occurs, so it does not take less than 24 hours from the appearance of the first symptoms to death.

At the very beginning of the disease, most patients notice a stabbing chest pain and cough. The pain intensifies on breathing, and the patient often lies on the side affected by inflammation to reduce chest movements. Coughing usually occurs on the third day of illness. It is purulent and thick, often with admixtures of blood. Herpes on the lips also occurs in about half. Breathing can be shallow and rapid, as can heart rate.

What are the complications of pneumococcal infection?

Most pneumococcal infections are milder in nature, but more severe forms of the disease can occur, which can result in brain damage or hearing loss, and death, especially in young children. Complications are suspected if the general condition worsens, the temperature is elevated for a long time, or the fever reappears after the temperature normalizes. In addition to pneumococcus spreading locally (sinuses, middle ear), it can enter the bloodstream (bacteremia) and the meninges (meningitis), heart (endocarditis), joints (septic arthritis), lung tissues (peritonitis) and other organs. Outbreaks and abscesses (pus buildup) can occur in the lungs or cause a condition called acute respiratory distress syndrome. ).
Pneumococcus is the most common cause of purulent meningitis in adults and is still often a fatal disease, depending on the patient’s condition (chronic or malignant disease, inadequate diet, age). In children up to five years of age who suffer from pneumococcal meningitis, the mortality is one in 15. It is characteristically manifested by fever with fever, headache, disturbance of consciousness (from confusion to coma) and braking of the neck. It occurs either as a primary infection of the meninges or, more often, it occurs by spreading from another place (lungs, ear, sinuses). Post-traumatic pneumococcal meningitis, which occurs after a fracture of the skull base, is also known.

How is pneumococcal pneumonia diagnosed?

The diagnosis can be established already on the basis of a well-done conversation with the patient, the clinical picture and the usual medical examination. Additional tests include X-rays of the lungs, blood tests (with an emphasis on changes in the number of leukocytes, neutrophils, CRP and sedimentation), and microscopic examinations and cultures of various samples (cough).