Pneumococcal pneumonia is an infection in the lungs. About five out of 100 people who are hospitalized with it will die from it; the elderly are at greater risk. It is estimated that almost 1 million people per year in the U.S. suffer from this illness, with almost half of those being hospitalized. It can spread to other areas of the body as an invasive disease with a higher mortality rate, especially for children under two years of age.
Symptoms of Pneumococcal Pneumonia
Symptoms can come on suddenly. These include:
- Severe chills
- High temperature
- Excessive sweating
- Pain upon breathing
- Chest pain
- Blood in sputum
- Confusion, especially in people over age 65
The most concerning symptoms that suggest an evaluation in the ER include:
- Difficulty Breathing
- High Temperature
- Low Oxygenation
Causes of Pneumococcal Pneumonia
Pneumonia can have many causes: bacterial, fungal, viral and others. Viruses that can infect the lungs include the flu virus, cold virus, herpes simplex virus, RSV (respiratory syncytial virus) and others. These pathogens account for 33-percent of pneumonias. What causes pneumococcal disease?
Streptococcus pneumoniae, also known as pneumococcus, is the bacteria responsible for this type of pneumonia. This pathogen resides in the mucous membranes of the respiratory systems of healthy adults and does not normally have adverse effects. In the elderly, the young and the immune-compromised, it can replicate into a full-blown infection. Beyond the lungs, it can invade the meninges of the nervous system, the circulatory system, the sinus cavity and the middle ear canal.
Pneumococcal pneumonia can strike at any time of the year. It is not the flu or a cold, although, there are higher rates of infection in the winter months. This being said, one does not get pneumonia from cold air. This is a common misconception. The actual culprit is having a cold or flu, which can increase the risk for a bacterial infection of the lungs.
The bacteria are spread via direct contact with an infected person through mucous secretions. A sneeze may send bacteria in liquid droplets into the air. A susceptible host might breathe in these droplets and become infected. A handshake or a contaminated doorknob might transmit the bug from one person to another. Taking care when around an infectious patient can prevent the spread.
Even though it can be directly contracted, outbreaks, where many people are infected, are rare. This might happen in an overcrowded, impoverished area. These bacteria do not spread as easily as a cold or the flu.
Risk Factors for Pneumococcal Pneumonia
There are a number of things that increase one’s chance of contracting this type of Pneumococcal pneumonia. Even a person without one of these risk indicators may become ill though. Beyond the initial infection, these aspects also portend increased chance of hospitalization as well as mortality. What are some of the risk factors?
Elderly over the age of 65 are at greater risk. As we age, our immune systems become less efficient, allowing pathogens an easier path to infection. The elderly are 13 times more likely to be in the hospital than the average adult with bacterial pneumonia; the average stay is six days.
Young children under the age of 2 have developing immune systems that are also vulnerable. Another risk factor for a young child is living in a group-care type of home. They show this to increase the odds of infection.
They also consider suffering from a chronic illness as a risk factor for Pneumococcal pneumonia. People with asthma, COPD (chronic obstructive pulmonary disease) or emphysema are more prone to this bacterial infection of the lungs. Someone fighting heart, liver or kidney disease is more susceptible. Additionally, having diabetes can give this infection easier entry into the lungs.
Compromised Immune System
When one is fighting cancer, the immune system may get suppressed, leading to a greater chance of Streptococcus pneumoniae infection. The spleen helps in the immune response. Patients who have had their spleen removed or damaged become more vulnerable. Persons with sickle disease may suffer acute splenic sequestration leading to bacterial infections from encapsulated organisms. HIV/AIDS reduces the body’s antibody response and is yet another risk factor. Unfortunately, diabetics are at increased risk.
People who smoke are at greater risk for many diseases, especially those involving the respiratory system. As can be expected, they are also more prone to pneumonia infection and have a higher hospitalization and mortality rate.
Once a person contracts bacterial pneumonia, complications can ensue. These involve the spread of the bacterium as well as localized irregular tissue involvement. These problems can be mild to severe and will often require medical attention. What are the potential complications?
Empyema, also known as purulent pleuritis or pyothorax, is when pus develops outside the lung but within the pleural cavity. This effusion cannot be coughed out; it needs to be removed by surgery or drained with a needle puncture. In some cases, this may lead to a pneumothorax, which is a collapsed lung, or even a potentially deadly immune system response known as sepsis.
Pericarditis is an inflammation in the tissues surrounding the heart. These tissues normally allow the heart to function by allowing a small bit of liquid to act as a lubricant as the heart beats. When there is excess liquid, there is friction and irritation of the membrane. The inflamed pericardium layers rub against each other, causing pain. This pain can come on quite quickly and range from mild to severe. Pericarditis may also upset the rhythm of the heart and cause abnormal beating.
A pus-filled inclusion in the lung is known as an abscess. The bacterial infection may destroy an area of alveoli. The resulting waste from the immune response leaves behind dead cells, bacteria, white blood cells and other detritus. This leftover material is known as pus. Once again, this further impedes proper breathing, leading to less oxygen getting to the vital organs of the body.
Bacterial pneumonia may lead to air sacs in the lungs deflating. When these alveoli become compromised, parts of the lung may collapse. This is known as atelectasis. Less oxygen will be delivered to the body, and breathing will become more difficult. This can exacerbate the overall illness, leading to a worse prognosis in both children and the elderly.
An airway may become blocked, leading to decreased airflow into the lung. This may or caused by thick mucus or phlegm that becomes lodged in a bronchial tube. This type of blockage is what we call as endobronchial obstruction. As with the other complications, this loss of airflow reduces the oxygen in the bloodstream and results in a worse scenario for the patient.
Treatments for Pneumococcal Pneumonia
In most cases, pneumococcal pneumonia can be treated with antibiotics. Symptoms should begin to lessen in 24 to 36 hours, and many patients recover without further issues. In almost half the cases, though, the infection requires hospitalization. The elderly are the largest risk category, with many needing almost a week’s stay. They estimated, though, that about 30 percent of streptococcus pneumoniae are resistant to antibiotics.
They give broad-spectrum antibiotics to begin the treatment. Once the underlying strain of bacteria and its sensitivities are known, more targeted medicines are given. There are also vaccines that help in further combating the bacteria. This discussion is found in the prevention section.
Nebulizers with Albuterol and Atrovent are helpful in opening up the lung airways. The goal is to cough up the built-up phlegm associated with a pneumococcal infection.
Five in 100 cases of uncomplicated pneumococcal pneumonia seen in the hospital are fatal. Prevention might mean the difference between life and death, especially for someone over the age of 65. What can be done?
Prophylactic antibiotic treatment is not recommended. In most cases where a person comes in contact with an infected patient, there is no transmission. With this in mind, prophylactic treatment with antibiotics would have no effect.
There are over 90 strains, or serotypes, of streptococcus pneumoniae. Since this is the case, a previous infection will not provide immunity to most new infections.
There are currently two vaccines that combat the pneumococcal disease. Beyond these, they also recommended to get a flu vaccine each year to combat potential pneumonia, as the flu increases the risk for bacterial infection.
CDC recommended the pneumococcal conjugate vaccine for children under 2 years of age as well as all elderly past the age of 64. They recommend this for adults, ages 19 through 64 if there are other risk factors involved. This vaccine is effective against 13 types of streptococcus pneumoniae serotypes.
CDC recommended the pneumococcal polysaccharide vaccine for all the elderly but not for children under the age of 2. They also recommended that those aged 2 through 64 get the vaccine if they have higher risk factors.
Avoid Direct Exposure
Although pneumonia is not as easily disseminated as the flu or cold viruses, similar precautions might help prevent its spread. If you are sick, consider staying home from school or work. Don’t share items used for meals. Disinfect places that have been touched by an infectious patient. Wash hands often, making sure to do a thorough job.
Pneumococcal pneumonia is a bacterium-based infection of the lungs. Although there is a greater risk for the elderly and young children, this disease can strike even the healthiest person. Awareness of the symptoms can help in making informed choices. Knowledge about prevention might keep the infection from ever gaining a foothold and causing damage.Featured Image via Depositphotos