Strep pneumoniae: Presentation


Streptococcus pneumoniae

  • Presentation
    • Pneumonia
      • Most common cause of community-acquired pneumonia - hence the name, strep pneumoniae
      • Associated with “rusty” sputum
    • Meningitis
      • Most common cause of bacterial meningitis in adults
    • Otitis media and sinusitis
      • The most common organisms that cause otitis media are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella. 
    • Sepsis
      • Severe bacteremia can lead to sepsis
  • Treatment
    • Preventative
      • pneumococcal capsular vaccine (PCV)
        • Conjugated (to diphtheria toxin)
          • Capsule is not very immunogenic; attaching protein toxin increases immune response and duration of efficacy
        • Children (infants) 
        • Protects against 13 serotypes 
      • pneumococcal polysaccharide vaccine (PPSV)
        • No conjugated protein
        • Adults (elderly, high-risk) 
        • Protects against 23 serotypes 
    • Medical
      • Penicillin/amoxicillin (light) or ceftriaxone (severe)
        • Ceftriaxone used in meningitis or hospitalized pneumonia
        • Amoxicillin or penicillin used to treat otitis media and outpatient pneumonia
        • resistant strains are treated with vancomycin