STREPTOCOCCUSPNEUMONIAEYASHWANT KUMAR

GROUP 8

INTRODUCTIONTHE PNEUMOCOCCUS IS AN

ENCAPSULATED GRAM POSITIVE COCCUS.ELONGATED OR “LANCET-

SHAPED”,ARRANGED IN PAIRS (DIPLOCOCCI) AND SHORT CHAINS.

IT IS COVERED WITH POLYSACCHARIDE CAPSULE AND THEIR CELL WALL COMPONENT OF THE CELL IS TEICHOIC ACID AND PEPTIDOGLYCAN LAYER.

ITS ALSO CONTAINS CRP,PHOSPHOCHOLINE AND AMIDASE.

VIRULENCEIT IS DETERMINED BY ABILITY TO

COLONIZE OROPHARNX BY SURFACE PROTEIN ADHESIONS.

SPREAD INTO NORMALLY STERILE TISSUES BY PNEUMOLYSIN,IGA PROTEASE.

STIMULATE LOCAL INFLAMMATORY RESPONSE BY TEICHOIC ACID,PEPTIDOGLYCAN FRAGMENTS,AMIDASE,PNEUMOLYSIN

HYDROGEN PER OXIDE ,LEADS TO TISSUE DAMAGE AND PHOSPHOCHOLINE ,PROTECTED FROM OPSONISATION AND PHAGOCYTOSIS.

EVADE PHAGOCYTIC KILLING (POLYSACCHARIDE CAPSULE)

DISEASEPNENMONIA.(IN MOST OF THE

CASES)SINUSITIS AND OTITIS MEDIA.MENINGITIS.BACTEREMIA.PERICARDITIS AND

ENDOCARDITISSEPSIS.OSTEOMYELETIS.PERITONITIS AND BRAIN

ABSCESS.

MAIN SYMPTOMS OF INFECTION

CAUSES1. Cerebral palsy2. Chronic lung disease

(COPD, bronchiectasis, cystic fibrosis)3. Cigarette smoking4. Difficulty swallowing (due

to stroke, dementia, Parkinson's disease, or other neurological conditions)

5. Immune system problem ( Pneumonia in immuno-compromised host)

6. Impaired consciousness (loss of brain function due to dementia, stroke, or other neurologic conditions)

7. Living in nursing facility 8. Other serious illnesses, such as heart

disease, liver cirrhosis, or diabetes mellitus9. Recent surgery or trauma10. Recent cold, laryngitis, or flu

EDIDERMIOLOGYMOST INFECTIONS ARE CAUSED BY ENDOGENOUS SPREAD

FROM THE COLONIZED NASOPHARYNX OR OROPHARYNX TO DISTAL SITE(EG;LUNGS,SINUS,EARS,BLOOD,MENINGES)

COLONIZATION IS HIGHEST IN CHILDREN .INDUVIDUALS WITH ANTECEDENT VIRAL RESPIRATORY

TRACT DISEASE OR OTHER CONDITIONS THAT INTERFERE WITH BACTERIAL CLEARANCE FROM RESPIRATORY TRACT ARE INCREASED RISK FOR PULMONARY DISEASE.

CHILDREN AND ELDERLY PEOPLE ARE AT GREATER RISK OF MENINGITIS.

PEOPLE WITH HEMATOLOGIC DISORDER(EG;MALIGNANCY,SICKLE CELL DISEASE) OR FUNCTIONAL ASPLENIA ARE AT RISK FOR FULMINANT SEPSIS

ORGANISM IS UBIQUITOUS ,DISEASE IS MORE COMMON IN COOL MONTHS.

PERSON-TO-PERSON SPREAD THROUGH INFECTIOUS DROPLETS IS RARE.

Diagnosis :

Physical Examination Lab testing

PHYSICAL EXAMINATION :

CHEST X-RAY

CRACKLINGS VIA STETHOSCOPE

INCREASED RESPIRATORY RATE (children) , COUGH, PERTUSIS.

LABORATORY DIAGNOSISMICROSCOPY IS HIGHLY SENSITIVE,AS IS CULTURE,

UNLESS THE PATIENT HAS BEEN TREATED WITH ANTIBIOTICS.

ANTIGEN TEST FOR PNEUMOCOCCAL C POLYSACCHARIDE IS SENSITIVE WITH CSF (MENINGITIS) .

NUCLEIC-ACID –BASED TESTS .CULTURE REQUIRES USE OGF ENRICHED-NUTRIENT

MEDIA(EG;SHEEP BLOOD AGAR),ORGANISM HIGHLY SUSCEPTIBLE TO MANY ANTIBIOTICS, SO CULTURE CAN BE NEGATIVE IN PARTIALLY TREATED PATIENTS.

ISOLATES IDENTIFIED BY CATALASE (NEGATIVE), SUSCEPTIBILTY TO OPTOCHIN,AND SOLUBILTY IN BILE.

TREATMENTPENICILLIN IS THE DRUG OF CHOICE FOR

SUSCEPTIBLE STRAINS ,ALTHOUGH RESISTANCE IS INCREASINGLY COMMON.

FLUOROQUINOLONE OR VANCOMYCIN COMBINED WITH CEFTRIAXONE IS USED IN PATIENTS ALLERGIC TO PENCILLIN OR PENCILLIN RESISTANCE STRAINS.

IMMUNIZATION WITH 7-VALENT CONJUGATED VACCINE IS RECOMMENDED FOR CHILDRENS UNDER 2 YEARS, A 23-VALENT POLYSACCHARIDE VACCINE IS RECOMMENDED FOR ADULTS AT RISK FOR DISEASE.

OTHER ANTIBIOTIC DRUGS USED ARE AMOXILLIN,TETRACYCLINES,ERYTHROMYCIN, AZITHOMYCIN,CLARITHROMYCIN.

Prevention and control :

60 % pneumonia is bacterial origin

Vaccination : Pneumonococcal vaccines

Maintaining immuno competancy

To be cautious about cold and flu’s

No self medication

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