Pneumococcal Pneumonia: Symptoms, Diagnosis, and Treatment Guide

Pneumococcal Pneumonia: Symptoms, Diagnosis, and Treatment Guide

Question.  Write a short note on pneumococcal pneumonia.

Answer. It is caused by streptococcal pneumonia.
It is characterized by homogeneous consolidation of one lobe or more lobes or segments of a lung, hence, called lobar pneumonia

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Clinical Features of Pneumococcal Pneumonia.

1. It occurs at all ages but is common in early and adult life. It is the most common bacterial pneumonia following an upper respiratory tract infection. It is usually a sporadic disease, common in winter and spreads by droplet infection.
2. In children, the onset is sudden often with fever, chills and rigors, vomiting and convulsions. In adults, the onset is with fever, chills, cough, breathlessness and chest pain.
3. Shaking chills and rigors
4. Loss of apatite body ache and headache
5. Hemoptysis and weakness
6. The physical signs during an early stage of illness show decreased respiratory movements, impairment of percussion note, diminished breath sounds and often a pleural rub on the affcted side.

1. Later on, usually after 3 days, signs of consolidation appear.
2. During resolution, numerous coarse crackles crepitations are heard, indicating the liquefaction of alveolar exudate.

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pneumococcal pneumonia Investigations

1. Blood test: It reveals marked neutrophil leucocytosis.
2. Blood culture: It shows the presence of Streptococcus pneumonia.
3. Examination of sputum: Gram staining of sputum may demonstrate pneumococci.
4. Chest radiograph: In pneumococcal pneumonia, a homogeneous opacity is seen localized to the affcted lobe or segment which appears within 12–18 hours from onset of illness.
5. Serological test: It can detect pneumococcal antigen in the serum.
6. In some of the cases, fieroptic, bronchoscopic aspiration or transthoracic needle aspiration is required.

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Complications pneumococcal pneumonia.

1. Pulmonary:

1. Parapneumonic pleural effsion
2. Emphysema
3. Suppurative pneumonia or lung abscess
4. Acute respiratory distress syndrome
5. Pneumothorax

2. Extra pulmonary

1. Hepatitis, pericarditis, meningioencephalitis
2. Multiorgan failure
3. Ectopic abscess formation

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Management pneumococcal pneumonia.

1. Initially, oral amoxicillin should be given 500 mg 8 hourly or erythromycin 500 mg 6 hourly.
2. If patient is very ill or gram negative or staphylococcal infection is present IV ampicillin 0.5–1g 6 hourly + flcoxacillin 250–500 mg IV 6 hourly + gentamicin 60–80 mg every 8 hourly IV is given.
3. Antibiotic therapy should be given for 7–10 days.
4. Choice of antib iotic depends on the causative microorganisms.
5. Oxygen therapy is given in seriously ill patients. Oxygen should be delivered at very high rate.
6. Analgesics such as mefenamic acid 250–500 mg or pethidine 50–100 mg or morphine 10–15 mg IM or IV injections should be given.
7. Physiotherapy is given to patient by encouraging him to cough and to take deep breath as pleuritic pain disappears.