Pneumococcal Pneumonia

by National Institute of Health

Pneumococcal pneumonia mainly causes illness in children younger than 2 years old and adults 65 years of age or older. The elderly are especially at risk of getting seriously ill and dying from this disease. In addition, people with certain medical conditions such as chronic heart, lung, or liver diseases or sickle cell anemia are also at increased risk for getting pneumococcal pneumonia. People with HIV infection, AIDS, or people who have had organ transplants and are taking medicines that lower their resistance to infection are also at high risk of getting this disease.

Cause

Pneumonia can be caused by a variety of viruses, bacteria, and sometimes fungi. Pneumococcal pneumonia is an infection in the lungs caused by bacteria called Streptococcus pneumoniae. S. pneumoniae, also called pneumococcus, can infect the upper respiratory tracts of adults and children and can spread to the blood, lungs, middle ear, or nervous system.

The Centers for Disease Control and Prevention (CDC) estimates S. pneumoniae causes 40,000 deaths and 500,000 cases of pneumonia annually in the United States. The disease is responsible for 3,000 cases of meningitis (inflammation of lining of the spinal cord), 50,000 cases of bacteremia (bacteria in the blood), and 7 million cases of otitis media (inner ear infection) in the United States.

Transmission

At any given time, the noses and throats of up to 70 percent of healthy people contain pneumococcus. Children, generally, harbor more of the bacteria than adults. Pneumococcus is spread through breathing the bacteria into the lungs, bypassing normal immune system defenses. Researchers don't know what causes it to suddenly invade the lungs and the bloodstream to cause disease.

Symptoms

Pneumococcal pneumonia may begin suddenly, with a severe shaking chill usually followed by high fever, cough, shortness of breath, rapid breathing, chest pains.

There may be other symptoms as well nausea, vomiting, headache, tiredness, muscle aches.

Diagnosis

A health care worker diagnoses pneumonia based on symptoms, physical examination, laboratory tests, chest x-ray.

Different bacteria, viruses, and other germs also can cause pneumonia. Therefore, if you have any of the symptoms, you should get diagnosed early and start taking medicine, if appropriate. The presence of S. pneumoniae in the blood, saliva, or lung fluid helps lead to a diagnosis of pneumococcal pneumonia.

Treatment

Your health care worker usually will prescribe antibiotics, such as penicillin, to treat this disease. The symptoms of pneumococcal pneumonia usually go away within 12 to 36 hours after you start taking medicine.

Bacteria such as S. pneumoniae, however, are now capable of resisting and fighting off the powers of antibiotics to destroy them. Such antibiotic resistance is increasing worldwide because these medicines have been overused or misused. Therefore, if you are at risk of getting pneumococcal pneumonia, you should talk with your health care worker about taking steps to prevent it.

Prevention

The pneumococcal vaccine is the only way to prevent getting pneumococcal pneumonia. Vaccines are available for children and adults.

The CDC National Immunization Program (NIP) recommends that you get immunized against pneumococcal pneumonia if you are in any of the following groups. You are 65 years old or older. You have a serious long-term health problem such as heart disease, sickle cell disease, alcoholism, leaks of cerebrospinal fluid, lung disease (not including asthma), diabetes, or liver cirrhosis. Your resistance to infection is lowered due to HIV infection or AIDS; lymphoma, leukemia, or other cancers; cancer treatment with x-rays or drugs; treatment with long-term steroids; bone marrow or organ transplant; kidney failure; nephrotic (kidney) syndrome; damaged spleen or no spleen. You are an Alaskan Native or from certain Native American populations.

NIP also recommends that all babies and children younger than 23 months old be vaccinated against this disease with the recently licensed pneumococcal conjugate vaccine.

Complications

In about 30 percent of people with pneumococcal pneumonia, the bacteria invade the bloodstream from the lungs. This causes bacteremia, a very serious complication of pneumococcal pneumonia that also can cause other lung problems and certain heart problems.

Research

The National Institute of Allergy and Infectious Diseases (NIAID) supports research on more effective prevention and treatment approaches to control pneumonia and its causes, including developing and testing vaccines and treatments for the disease-causing microbes that cause pneumonia, stimulating research on the structure and function of these microbes, developing better and more rapid diagnostic tools, understanding the long-term health impact respiratory pathogens have in various populations, examining the effect of vaccines in high-risk populations, determining how pneumococcus causes disease and becomes resistant to antibiotics.

The pneumococcal conjugate vaccine for children is partially the result of crucial NIAID research in the early development of the vaccine. This vaccine helps prevent pneumococcal diseases in babies and toddlers and is the latest advance in developing vaccines against common bacterial infections. This effort was led in large part by NIAID for more than 30 years.

NIAID supports studies to develop improved pneumococcal conjugate vaccines for children worldwide. In one such study, NIAID researchers are working with The Gambia Government in West Africa and scientists from several international research institutions to test a pneumococcal conjugate vaccine in The Gambia. Health care experts have consistently identified pneumococcus as the most common cause of bacterial pneumonia in The Gambia. In a pattern typical of many developing areas, infant and child mortality rates in The Gambia are high, acute respiratory infections are a leading cause of death, and pneumococcus is the most common cause of these infections.

About the Author

NIH is the nation's medical research agency - making important medical discoveries that improve health and save lives. The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting medical research.