Streptococcus Pneumonia :Clinical Manifestations , Diagnosis and treatment

Streptococcus Pneumonia :Clinical Manifestations , Diagnosis and treatment


DISEASES:

NON-INVASIVE DISEASES:

SINUSITIS(MC)

  • The bacterial pathogens causing acute bacterial sinusitis in children and adolescents include 
  1. Streptococcus pneumoniae (= 30%)
  2. nontypable Haerrophilus influenzae (=20%).

Among community-acquired cases:

  1. S. pneumoniae
  2. Nontypable Haemophilus influenzae 
  • Are the most common pathogens, accounting for 50-60% of cases. 
  • Moraxella catarrhalis causes disease in a signigicant percentage (20%) of children but less often in adults. 

OTITIS MEDIA

  • (middle ear)(MC)
  • otitis media in infants & young children are streptococcus pneumonia (30%), Haemophilus influenza (20%) and Moraxella catarrhalis (12%).

PNEUMONIA

  • Streptococcus pneumonia or pneumococcus is the most common cause of community acquired acute pneumonia.
  • Lobar pneumonia refers to an acute bacterial infection that results in consolidation of a large portion of a lobe or an entire lobe.
  • Streptococcus pneumonia produces a picture of lobar pneumonia.

Empyema

  • Empyema is the most common complication of pneumococcal pneumonia.

INVASIVE DISEASES( bacteremia)

MENINGITIS (CNS)

  • Meningitis is the most common intracranial complication of otitis media
  • ENDOCARDITIS (CVS)
  • PERITONITIS (body cavity)
  • SEPTIC ARTHRITIS
  • UVEITIS
  • SUBDURAL EMPYEMA
  • OTHERS (appendicitis, salpingitis, soft tissue infections)

Produce milk borne diseases

Commonest Post splenectomy infection

Australian syndrome
  • Concurrence of pneumococcal pneumonia,endocarditis and meningitis.
Diagnosis:
  • Gold standard diagnosis:pathological examination of lung tissue.
  • Gram staining and culture of CSF or sputum.
  • Biomarkers:Prolactin levels increase and Passive agglutination testing(CRP)
Treatment
  • Amoxicillin for otitis media/sinusitis/pneumonia
  • Ceftriaxone +vancomycin for meningitis
  • Ceftriaxone/cefotaxime +vancomycin for endocarditis
  • Pencillin resestance due to alteration in pencillin binding protien.
Vaccine
  1. Polyvalent polysaccharide vaccine
  2. Polysaccharide protien vaccine
Indicated to 
  • Pt with dysfunctional spleen
  • Sickle cell anemia
  • Coeliac diseases
  • DM
  • HIV

Contraindicated

  • Child below 2
  • CSF leak
  • Lymhoreticular Maligancies
  • Alcholic Cirrhosis
  • Hodgkin’s disease
  • Organ transplant recepient
Exam Question
 

DISEASES:

NON-INVASIVE DISEASES:

  • SINUSITIS(MC)
  • OTITIS MEDIA (middle ear)(MC)
  • PNEUMONIA (lungs)(lobar & community acquired commonly)
  1. Complication :Empyema

INVASIVE DISEASES( bacteremia)

  • MENINGITIS (CNS)
  • ENDOCARDITIS (CVS)
  • PERITONITIS (body cavity)
  • SEPTIC ARTHRITIS
  • UVEITIS
  • SUBDURAL EMPYEMA
  • OTHERS (appendicitis, salpingitis, soft tissue infections)

Produce milk borne diseases

Commonest Post splenectomy infection

Australian syndrome
  • Concurrence of pneumococcal pneumonia,endocarditis and meningitis.
 Diagnosis:
  • Gold standard diagnosis:pathological examination of lung tissue.
  • Gram staining and culture of CSF or sputum.
  • Biomarkers:Prolactin levels increase and Passive agglutination testing(CRP)
Treatment
  • Amoxicillin for otitis media/sinusitis/pneumonia
  • Ceftriaxone +vancomycin for meningitis
  • Ceftriaxone/cefotaxime +vancomycin for endocarditis
  • Pencillin resestance due to alteration in pencillin binding protien.
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