what are the clinical features of pneumococcal pneumonia ??
- acute onset with prominent respiratory symptoms
- often preceded by flu like symptoms
- cough with rust coloured sputum
- high fevers and pleuritic chest pain is common
for who is bacteraemia more common?
females, excess alcohol, dry cough and COPD, diabetics and HIV infection
what investigations should be done?
CXR, blood tests and specific diagnostic
what would a CXR maybe show?
consolidation with air bronchograms, effusions and collapse due to retention of secretions can all be seen
This is the most often cause of confluent consolidation involving A COMPLETE LOBE
what indications of pneumococcal pneumonia would be seen in blood tests?
white cell count in >15 x10^9/L (90% polymorphonuclear leukocytosis)
inflammatory markers significantly elevated
ESR> 100 mm/hour
CRP> 100 mg/L
what specific diagnostic tests would be done
- counter- immunoelectrophoresis of sputum (CIE), urine and serum is more sensitive that sputum or blood cultures
- urinary antigen test detects C-polysaccharide
- pneumococcal PCR - low sensitivity and inferior to blood cultures
how is pneumococcal treated?
bacteria are sensitive to amoxicillic, doxycyclina and co-trimoxazole
