Definition

Pneumococcal pneumonia is a common but serious
infection and inflammation of the lungs. It is caused by
the bacterium Streptococcus pneumoniae.

Description

The gram-positive, spherical bacteria, Streptococcus
pneumoniae, is the cause of many human diseases,
including pneumonia. Although the bacteria can normally
be found in the nose and throat of healthy individuals,
it can grow and cause infection when the immune system
is weakened. Infection usually begins with the upper respiratory
tract and then travels into the lungs. Pneumonia
occurs when the bacteria find their way deep into the
lungs, to the area called the alveoli, or air sacs. This is the
functional part of the lungs where oxygen is absorbed
into the blood. Once in the alveoli, Streptococcus pneumoniae
begin to grow and multiply. White blood cells
and immune proteins from the blood also accumulate at
the site of infection in the alveoli. As the alveoli fill with
these substances and fluid, they can no longer function in
the exchange of oxygen. This fluid filling of the lungs is
how pneumonia is defined.

Those people most at risk of developing pneumococcal
pneumonia have a weakened immune system.

This includes the elderly, infants, cancer patients, AIDS
patients, post-operative patients, alcoholics, and those
with diabetes. Pneumococcal pneumonia is a disease that
has a high rate of hospital transmission, putting hospital
patients at greater risk. Prior lung infections also makes
someone more likely to develop pneumococcal pneumonia.
The disease can be most severe in patients who have
had their spleen removed. It is the spleen that is responsible
for removing the bacteria from the blood. Cases of
pneumonia, which is spread by close contact, seem to
occur most often between November through April. If
not treated, the disease can spread, causing continually
decreasing lung function, heart problems, and arthritis.

Causes and symptoms

Symptoms of bacterial pneumonia include a cough,
sputum (mucus) production that may be puslike or
bloody, shaking and chills, fever, and chest pain. Symptoms
often have an abrupt beginning and occur after an
upper respiratory infection such as a cold. Symptoms
may differ somewhat in the elderly, with minimal cough,
no sputum and no fever, but rather tiredness and confusion
leading to hypothermia and shock.

Diagnosis

The presence of symptoms and a physical exam that
reveals abnormal lung sounds usually suggest the presence
of pneumonia. Diagnosis is typically made from an
x ray of the lungs, which indicates the accumulation of
fluid. Additional tests that may be done include a complete
blood count, a sputum sample for microscopic
examination and culture for Streptococcus pneumoniae,
and possibly blood cultures.

Treatment

Depending on the severity of the disease, antibiotics
are given either at home or in the hospital. Historically,
the treatment for pneumococcal pneumonia has
been penicillin. An increasing number of cases of pneumococcal
pneumonia have become partially or completely
resistant to penicillin, making it less effective in
treating this disease. Other effective antibiotics include
amoxicillin and erythromycin. If these antibiotics are
not effective, vancomycin or cephalosporin may alternatively
be used.

Symptoms associated with pneumococcal pneumonia
can also be treated. For instance, fever can be treated
with aspirin or acetaminophen. Supplemental oxygen
and intravenous fluids may help. Patients are advised to
get plenty of rest and take increased amounts of fluids.
Coughing should be promoted because it helps to clear
the lungs of fluid.

Alternative treatment

Being a serious, sometimes fatal disease, pneumococcal
pneumonia is best treated as soon as possible
with antibiotics. However, there are alternative treatments
that both support this conventional treatment and
prevent recurrences. Maintaining a healthy immune system
is important. One way to do this is by taking the
herb, echinacea (Echinacea spp.). Getting plenty of rest
and reducing stress can help the body heal. Some practitioners
feel that mucus-producing foods (including dairy
products, eggs, gluten-rich grains such as wheat, oats,
rye, as well as sugar) can contribute to the lung congestion
that accompanies pneumonia. Decreasing these
foods and increasing the amount of fresh fruits and vegetables
may help to decrease lung congestion. Adequate
protein in the diet is also essential for the body to produce
antibodies. Contrast and constitutional hydrotherapy
can be very helpful in treating cases of pneumonia.
Other alternative therapies, including acupuncture,
Chinese herbal medicine, and homeopathy, can be very
useful during the recovery phase, helping the body to
rebuild after the illness and contributing to the prevention
of recurrences.

Prognosis

Simple, uncomplicated cases of pneumococcal
pneumonia will begin to respond to antibiotics in 48 to
72 hours. Full recovery from pneumonia, however, is
greatly dependent on the age and overall health of the
individual. Normally, healthy and younger patients can
recover in only a few days, while the elderly or otherwise
weakened individuals may not recover for several weeks.
Complications may develop which give a poorer prognosis.
Even when promptly and properly diagnosed, such
weakened patients may die of their pneumonia.

Prevention

Vaccination

Recently, a vaccination has become available for
the prevention of pneumococcal pneumonia. This vaccination
is generally recommended for people with a high
likelihood of developing pneumococcal infection or for
those in whom a serious complication of infection is likely
to develop. This would include persons over the age of
65, as well as those with: