Streptococcus pneumoniae (patient information)

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Overview
Pneumonia is a breathing (respiratory) condition in which there is an infection of the lung. Community-acquired pneumonia is pneumonia in people who have not recently been in the hospital or another health care facility (nursing home, rehabilitation facility).

What are the symptoms of Streptococcus pneumoniae?
The most common symptoms of pneumonia are: Other symptoms include:
 * Cough (with some pneumonias you may cough up greenish or yellow mucus, or even bloody mucus)
 * Fever, which may be mild or high
 * Shaking chills
 * Shortness of breath (may only occur when you climb stairs)
 * Confusion, especially in older people
 * Excess sweating and clammy skin
 * Headache
 * Loss of appetite, low energy, and fatigue
 * Sharp or stabbing chest pain that gets worse when you breathe deeply or cough

What causes Streptococcus pneumoniae?
Pneumonia is a common illness that affects millions of people each year in the United States. Germs called bacteria, viruses, and fungi may cause pneumonia. Ways you can get pneumonia include: Pneumonia caused by bacteria tends to be the most serious kind. In adults, bacteria are the most common cause of pneumonia. Many other bacteria can also cause pneumonia. Viruses are also a common cause of pneumonia, especially in infants and young children. See also: Respiratory syncytial virus
 * Bacteria and viruses living in your nose, sinuses, or mouth may spread to your lungs.
 * You may breathe some of these germs directly into your lungs.
 * You breathe in (inhale) food, liquids, vomit, or fluids from the mouth into your lungs (aspiration pneumonia)
 * The most common pneumonia-causing germ in adults is Streptococcus pneumoniae (pneumococcus).
 * Atypical pneumonia, often called walking pneumonia, is caused by bacteria such as Legionella pneumophila, Mycoplasma pneumoniae, and Chlamydophila pneumoniae.
 * Pneumocystis jiroveci pneumonia is sometimes seen in people whose immune system is not working well.

Who is at highest risk?
Risk factors (conditions that increase your chances of getting pneumonia) include:
 * Cerebral palsy
 * Chronic lung disease (COPD, bronchiectasis, cystic fibrosis)
 * Cigarette smoking
 * Difficulty swallowing (due to stroke, dementia, Parkinson's disease, or other neurological conditions)
 * Immune system problem (See also: Pneumonia in immunocompromised host)
 * Impaired consciousness (loss of brain function due to dementia, stroke, or other neurologic conditions)
 * Living in a nursing facility
 * Other serious illnesses, such as heart disease, liver cirrhosis, or diabetes mellitus
 * Recent surgery or trauma
 * Recent cold, laryngitis, or flu

When to seek urgent medical care?
In case you feel you are developing symptoms of Pneumonia contact your doctor.

Diagnosis
If you have pneumonia, you may be working hard to breathe, or breathing fast. The health care provider will hear crackles when listening to your chest with a stethoscope. Other abnormal breathing sounds may also be heard through the stethoscope or via percussion (tapping on your chest wall). The health care provider will likely order a chest x-ray if pneumonia is suspected. Some patients may need other tests, including:
 * Arterial blood gases to see if enough oxygen is getting into your blood from the lungs
 * CBC to check white blood cell count
 * CT scan of the chest
 * Gram's stain and culture of your sputum to look for the bacteria or virus that is causing your symptoms
 * Pleural fluid culture if there is fluid in the space around the lungs

Treatment options
Your doctor must first decide whether you need to be in the hospital. If you are treated in the hospital, you will receive: It is very important that you are started on antibiotics very soon after you are admitted. You are more likely to be admitted to the hospital if you: However, many people can be treated at home. If bacteria are causing the pneumonia, the doctor will try to cure the infection with antibiotics. It may be hard for your health care provider to know whether you have viral or bacterial pneumonia, so you may receive antibiotics. Your doctor may tell you to take antibiotics. Antibiotics help most people with pneumonia get better. Coughing helps clear your airways. Take a couple of deep breaths two or three times every hour. Deep breaths will help open up your lungs. Tap your chest gently a few times a day and lie with your head lower than your chest. This can help bring up mucus from the lungs. If you smoke any tobacco products, STOP. Do not allow smoking in your home. Drink plenty of liquids (as long as your health care provider says it is okay): Get plenty of rest when you go home. If you have trouble sleeping at night, take naps during the day.
 * Fluids and antibiotics in your veins
 * Oxygen therapy
 * Breathing treatments (possibly)
 * Have another serious medical problem
 * Have severe symptoms
 * Are unable to care for yourself at home, or are unable to eat or drink
 * Are older than 65 or a young child
 * Have been taking antibiotics at home and are not getting better
 * Don't miss any doses. Take the medicine until it is gone, even if you start to feel better.
 * Do NOT take cough medicine or cold medicine unless your doctor says it is okay. Coughing helps your body get rid of mucus from your lungs. Breathing warm, moist (wet) air helps loosen the sticky mucus that may make you feel like you are choking. These things may help:
 * Place a warm, wet washcloth loosely over your nose and mouth.
 * Fill a humidifier with warm water and breathe in the warm mist.
 * Drink water, juice, or weak tea
 * Drink at least 6 to 10 cups a day
 * Do NOT drink alcohol

Where to find medical care for Streptococcus pneumoniae?
Directions to Hospitals Treating Streptococcus pneumoniae

What to expect (Outlook/Prognosis)?
With treatment, most patients will improve within 2 weeks. Elderly or very sick patients may need longer treatment. Those who may be more likely to have complicated pneumonia include: Your doctor may want to make sure your chest x-ray becomes normal again after you take a course of antibiotics. However, it may take many weeks for your x-ray to clear up.
 * Older adults or very young children
 * People whose immune system does not work well
 * People with other, serious medical problems such as diabetes or cirrhosis of the liver

Possible complications
Possible complications include:
 * Acute respiratory distress syndrome (ARDS)
 * Fluid around the lung (pleural effusion)
 * Lung abscesses
 * Respiratory failure (which requires a breathing machine or ventilator)
 * Sepsis, which may lead to organ failure