VPMD: Streptococcus pneumoniae (Pneumococcal)
What is Strep pneumoniae?
Streptococcus pneumoniae is bacterium that causes several infectious diseases, with pneumonia, as its name implies, being the most notable one. Some serious infections caused by Strep pneumoniae include meningitis and bacteremia, it is also a common cause of sinus and ear infections. Infants, older persons and immunocompromised are at increased risk for serious infections and their complications. Strep pneumoniae is contagious and passed from person to person through respiratory secretions.
What are the symptoms?
As a result of the different systems that can be infected by this bacteria, the presenting symptoms will vary.
Respiratory infections usually present with runny nose, cough, congestion, fever. It can also include chest pain, shortness of breath in pneumonia; headache, face pain, sore throat in sinusitis and ear pain in ear infections.
Meningitis usually presents with headache, fever, neck pain/stiffness, sensitivity to light, abnormal behavior, fussiness, decreased oral intake in infants .
Blood infection (bacteremia) presents insidiously with symptoms including fatigue and fever
Diagnosis of the respiratory infections are made based on symptoms and history, while the more serious infections require demonstration of bacteria in the blood and/or cerebrospinal fluid.
As the types of infections vary, so do their complications. Complications of meningitis include hearing loss, delayed neurological development. Bacteremia can be complicated by bone/joint infection, blood clots, heart infection (endocarditis) just to name a few. Pneumonia can be complicated by pericarditis, lung abscesses, empyema and respiratory failure. Ear infections may be complicated by mastoiditis and sinusitis by infection of the frontal bone, or intracranial spaces. All of the infections can lead to sepsis and death.
How is it treated?
Antibiotics that are active against Strep Pneumoniae are central to the treatment of any pneumococcal infection. Type and duration of antibiotics depends on the severity of the infection and susceptibility.
Supportive management of symptoms also play a role.
How is it prevented?
There are two types of vaccines, the Pneumococcal conjugated (PCV) vaccine which is indicated for all persons, starting in infancy with the primary series/booster and in those >/= 50 years old. Those with certain medical conditions and older adults are given the Pneumococcal Polysaccharide (PPSV) to broaden their coverage against the highly genetically variable bacteria. If a dose of PCV 20 has been given, then PPSV23 is usually not required.
Sources: CDC, AAP, NIH