Pneumonococcal Pneumonia

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1
CO
Streptococcus pneumoniae
2
Classification of CO
-gram positive diplococcus
-many capsular polysaccharide serotypes
-produces pore forming toxin (pneumolysin, lyses epithelial cells)
3
R, carriage levels in pop?
Humans
-10% of adult population are carriers
-70% of children under 3 are carriers
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POI
respiratory tract
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MOT
-airborne
-direct transmission
-respiratory droplets
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Peak infection times?
winter and early spring
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Incubation
1-3 dys
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Pathogenesis
-encapsulated pneumococci colonie alveoli and trigger inflammatory response
-toxin produced (pneumolysin) induces damage to cell membrane
-localized inflammation leads to alveolar fluid accumulation
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Symptoms
-productive cough (may include blood)
-weakness/fatigue
-chest pain when breathing
-fever and chills
-hypoxia
-rapid pulse
-confusion or low alertness in elderly
-sometimes nausea, vomiting or headache
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Complications?
-meningitis
-bacteremia
-sepsis
-infections of other organ systems (middle ear or sinus)
-pericarditis
-infection of chest cavity
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Moratility %
5% up to 20% in elderly
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Prevention, be specific
Vaccination (PCV13) pneumococcal polysaccharide-protein conjugate
-3 doeses at specific times
(PPSV23) protection against 23 serotypes
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Treatment
-Antibiotics (B-lactam)
*PCN and Cefotazime
*macrolide antibiotics
*Vancomycin
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