Streptococcus Pneumoniae-Pneumonia
by Annie Lee
Pneumonia (typical) (Pneumococcus) Streptococcus pneumoniae

Background Information:
S. Pneumoniae is a type of bacteria that can cause a wide rage of diseases. I.e.- bronchitis, ear infections, blood poisoning, meningitis, otitis media. In this report I will be focusing in on pneumonia. These diseases are fatal for about 20% of the infected population. Pneumonial bacteria are present in some healthy throats, and when the body's defenses are weakened the bacteria multiply. They work their way into the lungs and inflame the air sacs.

Victims: Until 1936, pneumonia was the number one cause of death in the US. Because of antibiotics, that statistic has decreased. Now, the flu and pneumonia share the number five spot for the leading causes of death.

Pathogenesis:
1) The pneumococcal surface will bind to lungs.
2) The pneumococci will aspirate into the lungs (45% of the time during sleep)
3) The pneumococcal cell wall will induce a dramatic inflammatory response.
4) The lungs may fill with protein rich fluid.
All five of the lung sacs may fill (called consolidation) and the disease with quickly spread into the bloodstream. Oxygen then has trouble reaching the blood, so one's body cells cannot work properly.

(Photo courtesy of the University of Florida College of Medicine, DatcaoPham@hotmail.com ) (Photo courtesy of the University of Florida College of Medicine, DatcaoPham@hotmail.com )
An example of RLL pneumococcal pneumonia. Notice the density on lower thoracic spine on lateral film.

Symptoms:
--shaking chills
--chattering teeth
--severe chest pain
--cough that produces rust-colored or greenish mucus
--high temperature
--heavy perspiring
--rapid pulse
--rapid breathing
--bluish color to lips and nailbeds
--confused mental state or delirium
--temperature of 105F is common in pneumonia patients

Who's at risk?:
-- elderly patients or those will chronic illnesses
-- alcoholics
-- post-operative patients
-- those with respiratory diseases or viral infections
-- those with weakened immune systems

Prognosis:
If you develop pneumonia, your chances of a fast recovery are greatest under certain conditions: "if you're young, if your pneumonia is caught early, if your defenses against disease are working well, if the infection hasn't spread, and if you're not suffering from other illnesses".

In the young and healthy, early treatment with antibiotics can cure bacterial pneumonia and speed recovery from mycoplasma pneumonia, and a certain percentage of rickettsia cases.

In brief, one's survival is dependent upon their age, overall health, medical history, extent of the disease, and tolerance for specific medications, among other things.

Diagnosis:
A medical professional must diagnose this disease physiologically, and therefore must take a throat culture. If this culture shows a Gram stain of a colony that shows Gram (+) diplococci and neutrophils, then you may have pneumonia. In addition, CXR typically shows lobar consolidation (pus matter in the air sacs).

Treatment:
The drug choice is basically up to the doctor. After the patient's temperature returns to normal, drugs must be administered to avoid a relapse. Penicillin is the drug of choice for sensitive organisms. However, recently, there is a concern for the development of penicillin resistant S. pneumonia. Cephalosporins and erythromycin are also effective.

In more serious cases, patients stay in the hospital and are put on an IV, where their blood pressure and heart rate are monitored. The pus in the air sacs may have to be removed by a needle. Besides this, doctors may ask you to eat an appropriate diet and undergo oxygen therapy.

Prevention:
Because pneumonia is a common complication of influenza (flu), getting a flu shot every fall is good pneumonia prevention. One dose of Pneumovax (pneumococcal vaccine) is recommended for patients over age 65 or patients with chronic disease. Your doctor can help you decide if you, or a member of your family, need the vaccine against pneumococcal pneumonia. It is usually given only to people at high risk of getting the disease and its life-threatening complications. It is usually given only once, and is not recommended for all people.

Works Cited:

http://www.cdc.gov/ncidod/diseases/hip/pneumonia/1_bactpn.htm
http://www.hsc.wvu.edu/som/micro/MB26PRINT/lecture29.30.31/sld015.htm
http://www.medinfo.ufl.edu/year4/imi/projects/pneumo/pneumonia.htm

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