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Section 5
Appendices

The following text is from an archived Red Book® edition and may not reflect current recommendations or information. To view the current edition, click here.

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Section 3. Summaries of Infectious Diseases

Pneumococcal Infections 1

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

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CLINICAL MANIFESTATIONS: Before routine use of heptavalent pneumococcal conjugate vaccine (PCV7), Streptococcus pneumoniae was the most common bacterial cause of acute otitis media and of invasive bacterial infections in children. Pneumococci also are a common cause of sinusitis, community-acquired pneumonia, and conjunctivitis. Pneumococci and meningococci are the 2 most common causes of bacterial meningitis in infants and young children. Pneumococcus occasionally causes periorbital cellulitis, endocarditis, osteomyelitis, pericarditis, peritonitis, pyogenic arthritis, soft tissue infection, and neonatal septicemia.


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ETIOLOGY: Streptococcus pneumoniae organisms (pneumococci) are lancet-shaped, gram-positive diplococci. At least 90 pneumococcal serotypes have been identified. Serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F (Danish serotyping system) cause most invasive childhood pneumococcal infections in the United States and are the 7 types contained in the licensed heptavalent pneumococcal conjugate vaccine. Serotypes 6B, 9V, 14, 19A, 19F, and 23F are the most common isolates associated with resistance to penicillin.


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EPIDEMIOLOGY: Pneumococci are ubiquitous, with many people having colonization of their upper respiratory tract. Transmission is from person to person, presumably by respiratory droplet contact. The period of communicability is unknown and may be as long as the organism is present in respiratory tract secretions but probably is less than 24 hours after effective antimicrobial therapy is begun. Among young children who acquire a new pneumococcal serotype in the nasopharynx, illness (eg, otitis media) occurs in approximately 15%, usually within 1 month of acquisition. Viral upper respiratory tract infections, including influenza, may predispose to pneumococcal infections. Pneumococcal infections are most prevalent during winter months. Rates of infection are highest in infants, young children, the elderly, and black, Alaska Native, and some American Indian populations. Also, these infections are increased in incidence . . . [Go to Full Text]


Related text in Red Book:

Immunocompromised Children

Red Book 2006: 71-85. [Extract] [Full Version]  

Human Immunodeficiency Virus Infection

Red Book 2006: 378-401. [Extract] [Full Version]  



This topic has been referenced by these articles:

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  • Hoffman, J. A., Mason, E. O., Schutze, G. E., Tan, T. Q., Barson, W. J., Givner, L. B., Wald, E. R., Bradley, J. S., Yogev, R., Kaplan, S. L. (2003). Streptococcus pneumoniae Infections in the Neonate. Pediatrics 112: 1095-1102 [Abstract] [Full Version]  
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  • Prosser, L. A., Ray, G. T., O'Brien, M., Kleinman, K., Santoli, J., Lieu, T. A. (2004). Preferences and Willingness to Pay for Health States Prevented by Pneumococcal Conjugate Vaccine. Pediatrics 113: 283-290 [Abstract] [Full Version]  
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  • Kaplan, S. L., Mason, E. O Jr, Wald, E. R., Schutze, G. E., Bradley, J. S., Tan, T. Q., Hoffman, J. A., Givner, L. B., Yogev, R., Barson, W. J. (2004). Decrease of Invasive Pneumococcal Infections in Children Among 8 Children's Hospitals in the United States After the Introduction of the 7-Valent Pneumococcal Conjugate Vaccine. Pediatrics 113: 443-449 [Abstract] [Full Version]  
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