Pediatric Pneumococcal Infections Differential Diagnoses

  • Author: Meera Varman, MD; Chief Editor: Russell W Steele, MD   more...
 
Updated: Sep 8, 2011
 
 
 
Contributor Information and Disclosures
Author

Meera Varman, MD  Associate Professor, Department of Pediatrics, Section of Pediatric Infectious Diseases, Creighton University Medical Center

Meera Varman, MD is a member of the following medical societies: American Academy of Pediatrics, Infectious Diseases Society of America, and Pediatric Infectious Diseases Society

Disclosure: phamaceutical companies Honoraria Speaking and teaching; phamaceutical companies Grant/research funds clinical trials

Coauthor(s)

Archana Chatterjee, MD, PhD  Professor of Pediatrics, Medical Microbiology and Immunology, and Pharmacy, Division of Pediatric Infectious Diseases, Chief of Division of Pediatric Infectious Diseases, Creighton University School of Medicine; Hospital Epidemiologist and Medical Director of Infection Control, Children's Hospital

Archana Chatterjee, MD, PhD is a member of the following medical societies: American Academy of Pediatrics, American Society for Microbiology, International Society for Infectious Diseases, Pediatric Infectious Diseases Society, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Nancy A Wick, MD  Consulting Staff, Department of Emergency Medicine, Section of Pediatrics, Children's at Scottish Rite

Nancy A Wick, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Emergency Physicians, American Medical Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

David Jaimovich, MD  Chief Medical Officer, Joint Commission International and Joint Commission Resources

David Jaimovich, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Larry I Lutwick, MD  Professor of Medicine, State University of New York Downstate Medical School; Director, Infectious Diseases, Veterans Affairs New York Harbor Health Care System, Brooklyn Campus

Larry I Lutwick, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Robert W Tolan Jr, MD  Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine

Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility

Disclosure: Novartis Honoraria Speaking and teaching

Chief Editor

Russell W Steele, MD  Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, Chandy C. John, MD, MS, to the development and writing of this article.

References
  1. Jacobs MR, Good CE, Bajaksouzian S, Windau AR. Emergence of streptococcus pneumoniae serotypes 19A, 6C, and 22F and serogroup 15 in cleveland, ohio, in relation to introduction of the protein-conjugated pneumococcal vaccine. Clin Infect Dis. 2008;47:1388-95. [Medline].

  2. Jacobs MR, Bajaksouzian S, Bonomo RA, et al. Occurrence, distribution and origins of serotype 6C Streptococcus pneumoniae, a recently recognized serotype. J Clin Microbiol. Oct 29 2008;[Medline].

  3. Invasive pneumococcal disease in children 5 years after conjugate vaccine introduction--eight states, 1998-2005. MMWR Morb Mortal Wkly Rep. Feb 15 2008;57(6):144-8. [Medline]. [Full Text].

  4. Ulloa-Gutierrez R, Avila-Aguero ML. 6th International Symposium on Pneumococci and Pneumococcal Diseases. Expert Rev Vaccines. Aug 2008;7(6):725-8. [Medline]. [Full Text].

  5. Arditi M, Mason EO Jr, Bradley JS, et al. Three-year multicenter surveillance of pneumococcal meningitis in children: clinical characteristics, and outcome related to penicillin susceptibility and dexamethasone use. Pediatrics. Nov 1998;102(5):1087-97. [Medline].

  6. FDA. FDA Approves Pneumococcal Disease Vaccine with Broader Protection. US Food and Drug Administration; February 24, 2010. [Full Text].

  7. van Gils EJ, Veenhoven RH, Hak E, et al. Effect of reduced-dose schedules with 7-valent pneumococcal conjugate vaccine on nasopharyngeal pneumococcal carriage in children: a randomized controlled trial. JAMA. Jul 8 2009;302(2):159-67. [Medline].

  8. Scott JA, Ojal J, Ashton L, Muhoro A, Burbidge P, Goldblatt D. Pneumococcal conjugate vaccine given shortly after birth stimulates effective antibody concentrations and primes immunological memory for sustained infant protection. Clin Infect Dis. Oct 2011;53(7):663-70. [Medline]. [Full Text].

  9. Christie D, Viner RM, Knox K, et al. Long-term outcomes of pneumococcal meningitis in childhood and adolescence. Eur J Pediatr. Aug 2011;170(8):997-1006. [Medline].

  10. AAPCID. Pneumococcal infections. In: Pickering LK, ed. 2009 Red Book: Report of the Committee on Infectious Diseases. 28th ed. American Academy of Pediatrics; 2009:524-535.

  11. AAPCID. Therapy for children with invasive pneumococcal infections. American Academy of Pediatrics Committee on Infectious Diseases. Pediatrics. Feb 1997;99(2):289-99. [Medline].

  12. Abramowicz M. A pneumococcal conjugate vaccine for infants and children. Med Lett Drugs Ther. Mar 20 2000;42(1074):25-7. [Medline].

  13. Black S, Shinefield H, Fireman B, et al. Efficacy, safety and immunogenicity of heptavalent pneumococcal conjugate vaccine in children. Northern California Kaiser Permanente Vaccine Study Center Group. Pediatr Infect Dis J. Mar 2000;19(3):187-95. [Medline].

  14. Bradley JS, Kaplan SL, Tan TQ, et al. Pediatric pneumococcal bone and joint infections. The Pediatric Multicenter Pneumococcal Surveillance Study Group (PMPSSG). Pediatrics. Dec 1998;102(6):1376-82. [Medline].

  15. Copelovitch L, Kaplan BS. Streptococcus pneumoniae--associated hemolytic uremic syndrome: classification and the emergence of serotype 19A. Pediatrics. Jan 2010;125(1):e174-82. [Medline].

  16. Dagan R. The potential effect of widespread use of pneumococcal conjugate vaccines on the practice of pediatric otolaryngology: the case of acute otitis media. Curr Opin Otolaryngol Head Neck Surg. Dec 2004;12(6):488-94. [Medline].

  17. Deeks SL, Palacio R, Ruvinsky R, et al. Risk factors and course of illness among children with invasive penicillin-resistant Streptococcus pneumoniae.The Streptococcus pneumoniae Working Group. Pediatrics. Feb 1999;103(2):409-13. [Medline].

  18. Friedland IR, McCracken GH Jr. Management of infections caused by antibiotic-resistant Streptococcus pneumoniae. N Engl J Med. Aug 11 1994;331(6):377-82. [Medline].

  19. Gertz RE Jr, Li Z, Pimenta FC, et al. Increased penicillin nonsusceptibility of nonvaccine-serotype invasive pneumococci other than serotypes 19A and 6A in post-7-valent conjugate vaccine era. J Infect Dis. Mar 2010;201(5):770-5. [Medline].

  20. Kaplan SL, Mason EO Jr, Barson WJ, et al. Three-year multicenter surveillance of systemic pneumococcal infections in children. Pediatrics. Sep 1998;102(3 Pt 1):538-45. [Medline].

  21. Klein JO. The pneumococcal conjugate vaccine arrives: a big win for kids. Pediatr Infect Dis J. Mar 2000;19(3):181-2. [Medline].

  22. Levine OS, Farley M, Harrison LH, et al. Risk factors for invasive pneumococcal disease in children: a population-based case-control study in North America. Pediatrics. Mar 1999;103(3):E28. [Medline].

  23. Li ST, Tancredi DJ. Empyema hospitalizations increased in US children despite pneumococcal conjugate vaccine. Pediatrics. Jan 2010;125(1):26-33. [Medline].

  24. O'Brien KL, Santosham M. Potential impact of conjugate pneumococcal vaccines on pediatric pneumococcal diseases. Am J Epidemiol. Apr 1 2004;159(7):634-44. [Medline].

  25. Poehling KA, Talbot TR, Griffin MR, et al. Invasive pneumococcal disease among infants before and after introduction of pneumococcal conjugate vaccine. JAMA. Apr 12 2006;295(14):1668-74. [Medline].

  26. Robinson KA, Baughman W, Rothrock G, et al. Epidemiology of invasive Streptococcus pneumoniae infections in the United States, 1995-1998: Opportunities for prevention in the conjugate vaccine era. JAMA. Apr 4 2001;285(13):1729-35. [Medline].

  27. Rubin LG. Pneumococcal vaccine. Pediatr Clin North Am. Apr 2000;47(2):269-85, v. [Medline].

  28. Shinefield HR, Black S. Efficacy of pneumococcal conjugate vaccines in large scale field trials. Pediatr Infect Dis J. Apr 2000;19(4):394-7. [Medline].

  29. Siberry GK, Iannone R. Formulary. In: Johns Hopkins University, ed. The Harriet Lane Handbook: A Manual for Pediatric House Officers. 18 ed. Mosby-Year Book; 2008:697-1030.

  30. Steenhoff AP, Shah SS, Ratner AJ, et al. Emergence of vaccine-related pneumococcal serotypes as a cause of bacteremia. Clin Infect Dis. Apr 1 2006;42(7):907-14. [Medline].

  31. Tan TQ, Mason EO Jr, Barson WJ, et al. Clinical characteristics and outcome of children with pneumonia attributable to penicillin-susceptible and penicillin-nonsusceptible Streptococcus pneumoniae. Pediatrics. Dec 1998;102(6):1369-75. [Medline].

  32. Teele DW. Pneumococcal infections. In: Feigin RD, Cherry JD, eds. Textbook of Pediatric Infectious Diseases. Vol 1. 5th ed. Philadelphia, PA: WB Saunders Co; 2005.

  33. [Best Evidence] Todd JK. Streptococcus pneumoniae (Pneumococcus). In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia: WB Saunders Co;2007.

  34. Toltzis P, Jacobs MR. The epidemiology of childhood pneumococcal disease in the United States in the era of conjugate vaccine use. Infect Dis Clin North Am. Sep 2005;19(3):629-45. [Medline].

  35. Wadwa RP, Feigin RD. Pneumococcal vaccine: an update. Pediatrics. May 1999;103(5 Pt 1):1035-7. [Medline].

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Sputum Gram stain from a patient with a pneumococcal pneumonia. Note the numerous polymorphonuclear neutrophils and gram-positive, lancet-shaped diplococci. Courtesy of C. Sinave, MD, personal collection.
Table. Drug Comparison
DrugSensitive, MIC mcg/mLResistant isolate, MIC mcg/mL
Intermediate resistanceResistant
Penicillin/amoxicillin≤0.060.1-1≥2
Cefotaxime or ceftriaxoneNonmeningeal ≤1, meningeal ≤0.5Nonmeningeal 2, meningeal 1Nonmeningeal ≥4, meningeal ≥2
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