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Routine maternal immunizations for all pregnant women
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Pneumococcal pneumonia is the most serious clinical presentation of pneumococcal disease among adults. The incubation period is 1 to 3 days. Symptoms include an abrupt onset of fever and chills with other symptoms such as pleuritic chest pain, cough, productive of purulent, rusty sputum, dyspnea, tachypnea, hypoxia, tachycardia, malaise, and weakness.
Infectious diseases (and tropical medicine and sexually transmitted diseases)
Published in Shibley Rahman, Avinash Sharma, A Complete MRCP(UK) Parts 1 and 2 Written Examination Revision Guide, 2018
Shibley Rahman, Avinash Sharma
Characteristic features of pneumococcal pneumonia: rapid onsethigh feverpleuritic chest painherpes labialis
Benzylpenicillin (Penicillin G)
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Alasdair M. Geddes, Ian M. Gould, Jason A. Roberts, Jason A. Trubiano, M. Lindsay Grayson
The distinctive signs and symptoms of pneumococcal pneumonia are sudden onset of fever, cough, and some sputum; the patient appears ill and has a grayish appearance. Pleuritic pain is often present. Crackling sounds are usually audible in the chest and radiographs show an area of infiltration, involving less than a full segment. Sputum microscopy is often helpful if a good specimen of sputum is collected. Crystalline Pen G in a dose of 0.6–1.2 g i.v. or i.m. every 6 hours, or, if necessary, higher doses to treat pneumococcal strains with intermediate type of resistance is indicated.
Role of the inflammatory response in community-acquired pneumonia: clinical implications
Published in Expert Review of Anti-infective Therapy, 2022
Alexander Rombauts, Gabriela Abelenda-Alonso, Guillermo Cuervo, Carlota Gudiol, Jordi Carratalà
Despite their potential for benefit, we must note that corticosteroids have the potential to compromise the clearance of respiratory pathogens, particularly the influenza virus and S. pneumoniae. A propensity score matched study of 1846 critically ill patients with influenza pneumonia indicated that corticosteroid use was associated with increased mortality (hazard ratio of 1.32; 95% CI 1.08 to 1.60) [110]. The recent meta-analysis by the Cochrane group, looking at the effects of corticosteroids in patients with influenza pneumonia, confirmed these results among observational studies, with the caveat that confounding by indication was a major concern [111]. However, this association was lost in another study after adjusting for time-related differences [112]. Regarding pneumococcal pneumonia, Snijders et al. found no benefits with corticosteroid treatment, but they did find a decrease in the clinical cure rate by 30 days [113]. In a trial by Blum et al., which showed a reduction in time to clinical stability with corticosteroids, this effect was lost for pneumococcal pneumonia [114].
Systematic literature review of the disease burden and vaccination of pneumococcal disease among adults in select Asia-Pacific areas
Published in Expert Review of Vaccines, 2022
Terapong Tantawichien, Li Yang Hsu, Omer Zaidi, Mark Bernauer, Frieda Du, Eriko Yamada, Jin Oh Kim, Isaya Sukarom
Pneumococcal diseases, including pneumococcal pneumonia and invasive pneumococcal disease (IPD), are common and cause significant morbidity and mortality, with rates higher especially in low- and middle income countries (LMICs) [1]. Their burden is particularly high among the elderly and those with underlying medical conditions [2,3]. The age-standardized mortality rate from pneumococcal pneumonia across all ages globally in 2017 was estimated at 35.4 cases per 100,000 people, with higher rates in sub-Saharan Africa and Southeast Asia [4]. In a study by the Asian Network for Surveillance of Resistant Pathogens on community-acquired pneumonia (CAP) where 955 adults from 8 countries were included, the overall mortality rate was 7.3% and Streptococcus pneumoniae [S. pneumoniae] was identified as the most common isolate (29.2%) [5]. Pneumococcal pneumonia is the leading cause of lower respiratory infection morbidity and mortality globally, with 1,189,937 deaths and 197.05 million cases reported in the year 2016 [6].
Efficacy and effectiveness of a 23-valent polysaccharide vaccine against invasive and noninvasive pneumococcal disease and related outcomes: a review of available evidence
Published in Expert Review of Vaccines, 2021
Michael S. Niederman, Temitope Folaranmi, Ulrike K. Buchwald, Luwy Musey, Allan W. Cripps, Kelly D. Johnson
Conversely, in adults with rheumatoid arthritis, no difference in pneumococcal pneumonia incidence was demonstrated between the PPSV23 and placebo arms (2.6 [95% CI 0.7–9.5] vs 1.4 [95% CI 0.3–8.0] per 1000 patient-years [P= 0.523] in vaccinated and unvaccinated individuals, respectively) [68]. In this study, most participants received methotrexate (64.7% and 69.7% in the vaccine and placebo arms, respectively); 12.9% and 13.8% in the vaccine and placebo arms received tacrolimus. Previous research has demonstrated that tacrolimus treatment alone did not reduce PPSV23 immunogenicity compared with patients with rheumatoid arthritis who received disease-modifying anti-rheumatic drugs or steroids; however, methotrexate monotherapy and methotrexate/tacrolimus combination therapy were associated with notably lower PPSV23 immunogenicity compared with tacrolimus treatment [69]. In addition, lacking power, short follow-up period, and the low sensitivity of sputum or blood culture, which were used to diagnose pneumococcal pneumonia in some study participants, may have contributed to the results of this study [68].