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Unusual manifestations of invasive pneumococcal infection

S N Taylor1, C V Sanders

  • 1Louisiana State University Medical Center, Department of Medicine, New Orleans 70112, USA.

The American Journal of Medicine
|August 18, 1999
PubMed

Insights

Unusual pneumococcal infections, though rare, are increasing due to antibiotic resistance and HIV. Clinicians must recognize these diverse, serious Streptococcus pneumoniae manifestations, even with modern medicine.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Clinical Medicine

Background:

  • Invasive pneumococcal disease (IPD) morbidity and mortality remain high despite advances in antibiotic therapy and medical technology.
  • IPD incidence has risen due to the human immunodeficiency virus (HIV) epidemic and the emergence of antibiotic-resistant Streptococcus pneumoniae.
  • Unusual pneumococcal infections, though less common today, still occur and pose significant clinical challenges.

Purpose of the Study:

  • To review and characterize unusual manifestations of pneumococcal infections.
  • To highlight the increasing incidence of IPD driven by HIV and antibiotic resistance.
  • To emphasize the need for clinicians to recognize and manage these diverse infections.

Main Methods:

  • A comprehensive literature review was conducted to identify and analyze cases of unusual pneumococcal infections.
  • The review identified 95 distinct types of unusual pneumococcal infections, encompassing 2,064 reported cases.
  • Predisposing underlying illnesses and conditions associated with IPD were also reviewed.

Main Results:

  • The literature review uncovered 95 different types of unusual pneumococcal infections, representing 2,064 cases.
  • Examples of unusual infections include pancreatic/liver abscesses, aortitis, phlegmonous gastritis, and necrotizing fasciitis.
  • Common risk factors for IPD include alcoholism, HIV infection, splenectomy, connective tissue disease, steroid use, diabetes mellitus, and intravenous drug use.

Conclusions:

  • Despite antibiotic availability, invasive pneumococcal disease continues to present with high morbidity and mortality.
  • The emergence of multidrug-resistant Streptococcus pneumoniae necessitates heightened clinical awareness of unusual presentations.
  • Clinicians must be prepared to diagnose and manage a wide spectrum of pneumococcal infections, especially in the context of potential antibiotic resistance and immunocompromised populations.

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