Related Experiment Video
Updated: Jul 16, 2026
Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria
Published on: February 23, 2014
Bacteremic pneumococcal pneumonia in the elderly
Abstract:
Pneumococcal pneumonia is an increasingly important disorder of the elderly. We reviewed, retrospectively, the clinical and laboratory manifestations of 29 elderly patients with bacteremic pneumococcal pneumonia during a five year period and surveyed the capsular serotypes of all blood isolates. Pneumococcal pneumonia frequently presented with subtle manifestations in these elderly patients: 50% lacked historical features suggestive of pneumonia at the time of diagnosis. A common presentation was fever, altered mental status and dehydration. Recognizing this will allow earlier diagnosis and initiation of therapy. Sixty percent of patients had potential pulmonary pathogens other than pneumococcus in cultures of sputum at the time of pneumococcal bacteremia. Reversible abnormalities of liver function were frequent. Sixty-nine percent of pneumonias were caused by serotypes included in the commercially available vaccine. Continued surveillance of pneumococcal serotypes is important to determine if the widespread use of the vaccine will result in an increased incidence of infection by serotypes which are not in the vaccine. The high mortality associated with pneumococcal pneumonia (31% in this series), particularly in the elderly, emphasizes the need for an effective vaccine.
Insights
Pneumococcal pneumonia in the elderly often presents subtly, with fever, confusion, and dehydration being common. Early recognition of these signs is crucial for timely treatment and reducing high mortality rates.
Area of Science:
- Medicine
- Infectious Diseases
- Geriatrics
Background:
- Pneumococcal pneumonia is a significant health concern in the elderly population.
- Bacteremic pneumococcal pneumonia presents unique diagnostic challenges in older adults.
Purpose of the Study:
- To review the clinical and laboratory features of bacteremic pneumococcal pneumonia in elderly patients.
- To identify common presentations and associated pathogens.
- To assess the prevalence of vaccine-serotype pneumococcal infections.
Main Methods:
- Retrospective review of 29 elderly patients with bacteremic pneumococcal pneumonia over five years.
- Analysis of clinical manifestations, laboratory findings, and sputum/blood cultures.
- Serotyping of blood isolates to determine capsular types.
Main Results:
- 50% of patients lacked typical pneumonia symptoms; common presentations included fever, altered mental status, and dehydration.
- 60% had other pulmonary pathogens identified alongside pneumococcus.
- Reversible liver function abnormalities were frequent.
- 69% of infections were caused by vaccine-included serotypes.
Conclusions:
- Subtle presentations of pneumococcal pneumonia in the elderly necessitate heightened clinical awareness for earlier diagnosis and treatment.
- The presence of other pathogens and reversible liver abnormalities are notable findings.
- Continued surveillance of pneumococcal serotypes is vital to monitor vaccine impact and emergence of non-vaccine types.
- The high mortality rate underscores the need for effective pneumococcal vaccines in this demographic.
Related Concept Videos
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:29Pneumonia II: Pathophysiology
01:30Pneumonia III: Complications and Assessment
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.
01:14Atypical Pneumonia
01:29Pneumonia I: Introduction