Pneumococcal disease

Pneumococcal disease is the term used to describe infections caused by the bacterium Streptococcus pneumoniae (also called the pneumococcus). This bacterium usually gains entry into the human host by colonising the nasopharyngeal epithelium. Pneumococcal infection is one of the most common causes of invasive bacterial infection in children. The pneumococcus is one of the most frequently reported causes of bacteraemia and meningitis. Invasive pneumococcal disease (IPD) is a major cause of morbidity and mortality, particularly affecting the very young, the elderly, asplenic (individuals without a spleen) and immunocompromised patients.


There is a marked seasonal pattern in the presentation of IPD with the greatest number of reports occurring between December and January.


Signs and Symptoms
The primary clinical features of pneumococcal disease include fever, chills, malaise and headache. Other signs and symptoms according to the body system afflicted:
 

  • The organism may spread locally into the sinuses or middle ear cavity, causing sinusitis or otitis media (middle ear infection), particularly in children. Children with ear infection may exhibit earache and decreased hearing
  • It may also affect the lungs to cause pneumonia: symptoms may include shortness of breath associated with cough
  • It may cause systemic (invasive) infections including bacteraemic pneumonia, bacteraemia and meningitis. Symptoms of meningitis include: nausea, vomiting, drowsiness, irritability and even unconsciousness
  • It may also cause peritonitis and arthritis

The pneumococcus is also the commonest cause of community-acquired pneumonia (CAP). In children the pneumococcus is the most common bacterial cause of otitis media.

Complications: Death occurs in 14% of hospitalized adults with invasive disease. Neurologic sequelae and/or learning disabilities can occur in meningitis patients. Hearing impairment can result from recurrent otitis media. 


Transmission
Pneumococcus is transmitted from person to person. 


Treatment
Pneumococcal disease is a contagious bacterial infection and, if detected early, needs only oral antibiotics along with symptomatic treatment. In serious conditions, intravenous administration of antibiotics may be needed. Symptomatic treatment includes anti-pyretic medications for fever and analgesic medications for pain. 


Prevention
Prevention of pneumococcal disease may be done with appropriate vaccination. Although there is no vaccine that can control all the different strains of pneumococcal bacteria, the commonly infecting pneumococcal bacteria may be prevented.

Since it is a contagious disease, care must be taken to avoid exposure to infected persons. Affected individuals must always cover his/her mouth while sneezing or coughing.