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
- Streptococcus pneumoniae (= 30%)
- nontypable Haerrophilus influenzae (=20%).
Among community-acquired cases:
- S. pneumoniae
- 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
- Polyvalent polysaccharide vaccine
- 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)
- 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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