Pneumococcal Infections

The pneumococcus is an abbreviation used for bacterium known as streptococcus pneumoniae. This bacterium belongs, as the name suggests, among the group of bacteria known as streptococci. The pneumococci are etiologic agents of many common infections including very serious ones. The pneumococci can infect the patients by a transmission of coughed up droplets that are inhaled and affect the respiratory system.

Diseases

Pneumonia

The pneumococcus is one of the most common bacterial causes of pneumonia. The bacteria usually infect the airways that have been previously weakened by a local viral infection. The symptoms include high body temperature, cough with expectoration of mucus and pus, chest pain and shortness of breath.

Tonsillitis

Pneumococcus can attack the tonsils and cause a classic tonsillitis. The disease is accompanied with high temperature, malaise and unpleasant sore throat. The pain usually worsens during swallowing. The tonsils are enlarged, reddish and covered with whitish coatings.

Otitis media

Pneumococcus is a common cause of the middle ear infection. It manifests by a strong ear pain, fever, malaise and sometimes even auditory problems. Perforation of the eardrum may be followed by a purulent discharge out of the affected ear

Sinusitis

The pneumococcus can invade the paranasal sinuses and cause their local infection. It is a very unpleasant condition with accumulation of pus in the cavities. While the cavities are connected with the nasal cavity by small holes, the inflamed mucosa swells and closes them causing a painful accumulation of the pus. The infection causes increased temperature and pain of the affected sinuses - most often in the area under the eyes or in the forehead above the nose. The antibiotic therapy is often ineffective and the otolaryngologists must perform the sinus puncture. The puncture aims to create a communication between the affected sinus and the nasal cavity to allow the drainage of pus. The puncture is painful, but it leads to a significant quick relief.

Meningitis

This is an infectious inflammation of the meninges (membranes covering the brain). It occurs more frequently in young children and the elderly. Sometimes, it can occur in a previously healthy individual, but it may also be a serious complication of an untreated anatomically close infection such as the pneumococcal sinusitis or otitis media. The disease has usually dramatic symptoms including very high fever, severe malaise, confusion, impairment of consciousness, headache and positive meningeal signs. The primary meningeal symptom is the inability to bend the head and touch the chest with the chin due to stiffness and pain of the back of the neck.

 

Pneumococcal meningitis surprisingly does not have that kind of publicity as the meningococcal meningitis. However, uncomplicated meningococcal meningitis kills "only" about 10% of the patients. Pneumococcal meningitis kills over 20% of patients and many survivors have lifelong consequences such as deafness and various neurological symptoms.

 

Any patient with a suspicion of meningitis should be cautiously examined by a skilled doctor, in ideal case by a neurologist or infectious diseases specialist. The blood tests usually show signs of inflammation including elevated sedimentation rate and elevated CRP. Computed tomography of the brain is important rather for exclusion of other possible organic diseases (brain tumors, strokes, etc.). Spinal tap (lumbar puncture) is probably the most precious examination method as the doctors obtain a sample of cerebrospinal fluid, which can be sent for a biochemical and microbiological examination to quickly confirm the infection and later also its causative agent. The condition must be treated in an inpatient department, usually in an intensive care unit by high doses of strong antibiotics and overall support of the basic vital functions.

Prevention of pneumococcal infections

Any bacterial inflammation of the face or head should be adequately treated, especially sinusitis and middle ear infections. There is also a vaccination against the pneumococcus, which is very effective in preventing the infection. In many countries, the vaccination against pneumococcal infections is automatically implemented only in patients with increased risk of the infection such as immunocompromised patients and children after surgical removal of the spleen. In the rest of the population, the vaccination is usually voluntary.