Streptococcus pneumoniae

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Streptococcus pneumoniae
SEM micrograph of S. pneumoniae.
SEM micrograph of S. pneumoniae.
Scientific classification
Domain: Bacteria
Phylum: Firmicutes
Class: Diplococci
Order: Lactobacillales
Family: Streptococcaceae
Genus: Streptococcus
Species: S. pneumoniae
Binomial name
Streptococcus pneumoniae
(Klein 1884)
Chester 1901

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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Streptococcus pneumoniae from other Diseases

Epidemiology & Demographics

Risk Factors

Natural History, Complications & Prognosis

Diagnosis

History & Symptoms | Physical Examination | Lab Tests | Chest X Ray | CT | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Antimicrobial therapy

  • Streptococcus pneumonia [1]
  • (1) Lung (pneumonia)
  • Community-acquired pneumonia
  • Penicillin sensitive (minimum inhibitory concentration ≤ 2)
Oral agents: Penicillin V 500 mg PO qid, Amoxicillin 500-1000 mg PO tid, Cefpodoxime 200 mg PO bd, Cefprozil 500 mg PO bd, Cefditoren 400 mg PO bd, Cefdinir 300 mg PO bd, OR Doxycycline 100 mg PO bd.
  • (2)Sinuses (sinusitis)
  • Sinusitis (empiric therapy)
  • (3)Middle ear (otitis media)
  • (4)Bronchi (acute exacerbation of chronic bronchitis)
  • (5)CNS (meningitis)
  • Empiric therapy
  • Penicillin sensitive (minimum inhibitory concentration ≤ 0.06)
  • Penicillin resistant (minimum inhibitory concentration ≥ 0.12) or beta-lactam hypersensitivity
  • Preferred regimen: Vancomycin 30-45 mg/kg/day IV.
Dexamethasone 0.15 mg/kg IV q6h for 2-4 days starting 10-20 min before antibiotic.
  • (6)Peritoneum (spontaneous bacterial peritonitis)
  • (7)Pericardium (purulent pericarditis)
  • (8)Skin (cellulitis)
  • (9)Eye (conjunctivitis)
  • Prevention
  • (1) Pneumovax (23-valent) prevents bacteremia; impact on rates of CAP are modest or nil.
  • (2) Prevnar vaccine for children <2 yrs age prevents invasive pneumococcal infection in adults by herd effect. Impact is impressive with rates of invasive pneumococcal infection down 80% in peds and 20-40% in adults.
  • (3) Risk for bacteremia in splenectomy, HIV, smokers, black race, multiple myeloma, asthma.

References

  1. Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580. 

Case Studies

Case #1


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