Streptococcus pneumonia infection also known as pneumococcal disease is an infection caused by Streptococcus pneumonia bacteria. These bacteria can affect to the different parts of the body causing different signs and symptoms depending on the site of infection. Pneumonia i.e., infection of the lungs, ear infections, sinus infections, meningitis i.e., infection of the covering around the brain, spinal cord and bacteremia covering blood stream infection. Streptococcus pneumoniae is communicable and spread from the infected person through coughing, sneezing, and close contact. The symptoms include fever, cough, shortness of breath, chest pain, stiff neck, confusion and disorientation, sensitivity to light, joint pain, chills, ear pain, sleeplessness, and irritability. In extreme cases Streptococcus pneumoniae infection can cause brain damage, hearing loss and death. Streptococcus pneumoniae infection mainly tends to occur in the elderly or in people with serious underlying medical conditions. Groups such as children under 2 years of age, children in childcare and Torres Strait Islander people. Streptococcus pneumoniae infection is usually diagnosed by microscopic examination and growth of bacteria from blood, sputum or other specimens. PCR (polymerase chain reaction) testing in a pathology laboratory is also used.
Four hundred fifty-two invasive pneumococcal infections were diagnosed in 1985 through 1989. The annual incidence rate was 8.9 per 100,000 children less than 16 years of age (24.2 per 100,000 among children less than 5 years of age and 45.3 per 100,000 among those less than 2 years of age). The most common clinical entities were bacteremia without focus (310 cases), pneumonia (66 cases), and meningitis (51 cases), with other focal infections seen in 25 cases. The pneumococcal groups/types 14, 6, 19, 7, 18, and 23 comprised 78% of all invasive infections. Laboratory-based surveillance of invasive pneumococcal infections in adults in Finland from 1983 to 1992 identified 862 episodes of pneumococcal bacteraemia and 97 episodes of meningitis. The overall incidence of invasive pneumococcal infections was 9•1 per 100000 for all adults per year, but 27•1, 35•8, and 44•5 per 100000 in those aged 65 years or over, 75 years or over, and 85 years or over, respectively. Most (99•7%) of the pneumococcal strains were sensitive to penicillin. Ninety-five percent of the strains belonged to sero groups/types present in the 23-valent pneumococcal polysaccharide vaccine. Group/type distribution was different in patients aged 16–64 years compared to those 65 years or over (P < 0•001), in bacteraemia compared to meningitis (P < 0•001), and in the years 1983–7 compared to 1988–92 (P < 0•05). Symptoms widely vary in patients with pneumococcal pneumonia, mild illness to febrile pneumonia to respiratory distress requiring ICU-level care.
Factors such as age, type of symptoms, and duration of symptoms, underlying or chronic illness, and compliance with treatment, appropriate home care and potential for worsening disease are considered in determining the need and level of hospitalization. Most hospitalized should be treated with parenteral antibiotics in addition to medications for pulmonary symptoms, pain medications, intravenous fluids or parenteral or enteral nutrition, oxygen, and additional medications, as indicated on an individual basis. The use of steroids in adult patients with bacterial meningitis is recommended with caution, as they may decrease CSF antibiotic concentration; patients with meningitis treated with steroids should be monitored closely. Steroids can be considered prior to antibiotic therapy in children aged 6 weeks and older with pneumococcal meningitis. They should be given before or at the time of first dose of antibiotics. Intravenous fluids, parenteral or enteral nutrition, and other medications should be used as indicated clinical instances. A patient with pneumococcal bacteremia is treated with appropriate antibiotics. Children who undergo workup to rule out serious bacterial illness but who are not treated initially with antibiotics and whose cultures subsequently grow S pneumoniae are often asymptomatic and have negative repeat blood culture findings at follow-up. Repeat blood cultures should always be obtained in patients with S pneumoniae bacteremia. Patients with cardiac, skin or soft-tissue, bone, and joint infections with S pneumoniae should usually be admitted to the hospital for observation, intravenous antibiotic therapy, expedition of further workup and evaluation of location.