What Is Streptococcus Pneumonia?

Streptococcus pneumoniae pneumonia, or pneumococcal pneumonia, is pneumonia caused by Streptococcus pneumoniae or pneumococcus, accounting for more than half of community-acquired pneumonia. It usually starts suddenly and is characterized by high fever, chills, cough, bloody sputum, and chest pain.

Basic Information

nickname

Pneumococcal pneumonia

Visiting department

Respiratory Medicine

Common locations

lung

Common causes

Streptococcus pneumoniae infection

Common symptoms

Fever, chills, weakness, cough and shortness of breath, etc.

Causes of Streptococcus pneumonia

Streptococcus pneumoniae pneumonia is pneumonia caused by Streptococcus pneumoniae or pneumococcus.

Clinical manifestations of streptococcus pneumonia

Patients with Streptococcus pneumoniae pneumonia often have acute illness, with symptoms of fever, chills, weakness, cough, and shortness of breath, and may have mucus, empyema, or rusty sputum.

Streptococcus pneumonia examination

Physical examination

Physical examination may have signs of pulmonary consolidation such as wet rales and percussion dullness.

Blood image

During systemic infection, the white blood cell count can increase significantly (20 to 30) × 10 ⁹ / L, with neutrophils accounting for 90%. In elderly people and those with low immune function, the white blood cell count does not increase significantly, but the classification is still 80% %the above.

3. Bacteriological examination

Smears of patients with purulent lesions (such as sputum, pus, and cerebrospinal fluid) should be used for bacterial culture. Patients with fever should also be cultured with blood. Streptococcus pneumoniae should be obtained as the diagnosis basis.

4. Cerebrospinal fluid examination

Meningitis patients have normal cerebrospinal fluid (CSF) with purulent changes, rice-like soup appearance, protein above 1g / L, white blood cell counts above 500 × 10 ⁶ / L, multinuclei predominate, sugar and chloride reduction.

5. Immunological examination

Detection of capsular polysaccharide antigen in serum and CSF by latex agglutination test or convection electrophoresis is helpful for the diagnosis of those with negative bacterial culture.

6.X-ray inspection

Exudative or consolidation lesions in X-ray examination are mostly limited to one or several lung segments in one lung lobe.

Diagnosis of Streptococcus pneumonia

Bacterial culture of various specimens is still the main method for pathogenic detection. Blood, cerebrospinal fluid, middle ear fluid, sinus exudate, thoracic exudate, and abdominal exudate and other sterile site specimens such as Streptococcus pneumoniae culture can be established. Because sputum specimens may be contaminated with nasopharyngeal parasites, sputum smear Gram staining and microscopic examination must be performed at the same time. If the microscopic examination is a qualified sputum specimen, when Streptococcus pneumoniae is cultured, the pathogen can be presumed to be Streptococcus pneumoniae; Strains of pneumococcus can also be obtained from blood culture, which can confirm the diagnosis of the pathogen. X-ray chest examination only showed increased lung texture at the beginning of the disease, and the consolidation phase showed a typical large dense shadow, most of which started from the right middle lobe or one lower lobe, mostly limited to one leaf, and a few could be limited to single-lung segment, and occasionally the leaf space Swell.

Streptococcus pneumonia treatment

Antibacterial treatment

Antimicrobial treatment should begin as soon as possible.

(1) Penicillin solution , intramuscular injection every 12 hours; if shock can be changed to intravenous injection, or until the body temperature drops to 72 hours after normal. Premature discontinuation may cause relapse. If the patient can be taken orally and is not suitable for injection, a procaine penicillin can be given first, followed by oral penicillin V. If the patient does not respond well to penicillin treatment, the following reasons should be considered: Pulmonary empyema, endocarditis, meningitis, and tumors cause pulmonary suppuration; pneumonia or pathogen resistance caused by other bacteria; Causes drug fever; When the diagnosis is wrong, sometimes starting treatment is effective, continuing treatment is not effective.

(2) Intramuscular or intravenous injection of cefotaxime . Effective but occasionally cross-allergic with penicillin, cephalosporin should be used for allergy tests before administration;

(3) intramuscular or intravenous injection of cefazolin .

(4) Oral administration of erythromycin is extremely rare in those who are resistant to erythromycin.

2. Support symptomatic therapy

(1) Rest in bed and gradually change to semi-liquid or soft food after the liquid food improves.

(2) Replenish liquids and electrolytes.

(3) Patients with shock should be given oxygen to replenish circulating blood volume to correct acidosis; in severe cases, 0.3% hydrogen peroxide can be injected intravenously, or phentolamine, anisodamine, atropine, or isoprenaline can be added to improve the condition. Microcirculation; Do not blindly give large amounts of booster drugs. The prognosis of the following cases is serious and should be paid attention to: elderly and infants; delays in treatment; Streptococcus pneumoniae type 2 and 3 infections; multi-leaf disease; significant decrease in white blood cell count; sepsis; detection of pods in blood by convection immunoelectrophoresis Membrane polysaccharide antigen; concurrent shock, endocarditis, meningitis, late pregnancy; patients with primary chronic heart, lung, liver, and kidney disease and low cellular immune function; patients with alcoholism, tremor and delirium, should receive chest X 3 to 4 weeks after recovery Line review.