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Management of Pneumococcal Infection
Date Posted: 17/Jan/2020
Pneumococcal infections are caused by the bacterium Streptococcus pneumoniae, also known as pneumococcus.  Pneumococci are commonly found in the upper respiratory tract of healthy people throughout the world. The bacteria spread through contact with people who are ill or by healthy people who carry the bacteria in the back of their nose.
 
Pneumococcal infections can be mild or severe. Although anyone can get pneumococcal disease, it tends to occur in the elderly or in people with serious underlying medical conditions.
 
S.pneumoniae is normally found in the noses and throats of about 10 per cent of healthy adults and 40 per cent of healthy children. It can be found in higher amounts in certain environments, especially in those places where people spend a great deal of time in close proximity to each other (day-care centres, barracks and overcrowded places).
 
People with a compromised immune system, such as those living with HIV, are also at higher risk of pneumococcal disease. In HIV patients with access to treatment, the risk of invasive pneumoccal disease is 0.2-1 per cent each year and it has a fatality rate of eight per cent.
 
Risk factors
 
The following groups of people are under risk: children under 2 years of age, children in childcare, those with sickle cell disease. Pneumococcal pneumonia is a serious infection of the lungs, which can be fatal, especially in the elderly or infants.
 
How pneumococcal infection is spread
 
Pneumococcal infection is spread when an infected person talks, coughs or sneezes small droplets containing infectious agents into the air. The droplets in the air may be breathed in by those nearby. Infection may be spread by contact with hands, tissues and other articles soiled by infected nose and throat discharges. Pneumococcal infections are more common during the winter and may be triggered by viral infections.
 
Signs and symptoms
 
The most common types of infections are ear infections, sinus infections, pneumonia, sepsis, meningitis. Pneumococcal pneumonia (lung infection) is the most common and serious form of pneumococcal disease. Symptoms include fever and chills, cough, shortness of breath, blood-stained or ‘rusty’ sputum (phlegm), rapid breathing or difficulty in breathing and chest pain.
 
Pneumococcal meningitis is an infection of the tissue covering the brain and spinal cord. The symptoms include stiff neck, fever, headache, photophobia (eyes being more sensitive to light) and confusion. In babies, meningitis may cause poor eating and drinking, low alertness, and vomiting.
 
Pneumococcal bacteraemia is a blood infection. The symptoms include fever, chills and low alertness. Also Sepsis is a complication caused by the body’s overwhelming and life-threatening response to an infection, which can lead to tissue damage, organ failure and death. The symptoms include confusion or disorientation, shortness of breath, high heart rate, fever, shivering, extreme pain or discomfort, clammy or sweaty skin.
 
Pneumococcal bacteria cause up to half of middle ear infections (otitis media). The symptoms include ear pain, a red, swollen ear drum, fever and sleepiness.
 
Complications
 
Most pneumococcal infections are mild. However, some can be deadly or result in long-term problems, such as brain damage or loss of hearing.
 
Meningitis is the most severe type of invasive pneumococcal disease. One out of 15 children younger than five years, who get pneumococcal meningitis, dies of the infection. The chance of death from pneumococcal meningitis is higher among elderly patients. Others may have long-term problems, such as loss of hearing or developmental delay.
 
Bacteraemia is a type of invasive pneumococcal disease that infects the blood. The chance of death from pneumococcal bacteraemia is higher among elderly patients.
 
Pneumonia is an infection of the lungs that can cause mild to severe illness in people of all ages. Complications of pneumococcal pneumonia include:
  • Diagnosis and tests
  • Bacteria culture test
  • Blood culture test
  • Chest x-ray.
  • vTreatment
Effective antibiotic therapy is available.
 
Prevention
 
There are two vaccines. One is for infants and young children. The other is for people at high risk, including those who are over 65 years old, have chronic illnesses or weak immune systems, smoke, have asthma, or live in long-term care facilities.
 
There are vaccines available to prevent streptococcus pneumoniae infection. Immunisation is routinely given to all children through the National Immunisation Programme.

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