Pneumococcal sepsis is a serious invasive infection with pneumococcal bacteria, otherwise known as pneumococcal disease. Patients with reduced immunity, especially young children and the elderly, are most at risk of developing pneumococcal sepsis.

Pneumococcal sepsis is one of the most severe forms of invasive pneumococcal infection. It is caused by the penetration of pneumococcal bacteria (diphtheria) into the blood, and thus to the most important organs in our body. Vaccination against pneumococci can prevent the development of sepsis - since 2022, they are included in compulsory vaccinations for children and reimbursed by the Ministry of He alth. Children can be vaccinated with the 10-valent vaccine (reimbursed) or the 13-valent vaccine, which parents can buy on their own.

Contents:

    1. Pneumococcal sepsis - how long does it last?
    2. Pneumococcal sepsis - source of infection
    3. Pneumococcal sepsis and other infections
    4. Pneumococcal sepsis. The main symptoms of sepsis
    5. Pneumococcal sepsis - diagnosis
    6. Pneumococcal sepsis - prognosis and treatment
    7. Pneumococcal sepsis - complications

Pneumococcal sepsis is a systemic inflammatory reaction in the body that can lead to multi-organ failure, and therefore - if untreated - to the patient's death.

Pneumococcal sepsis - how long does it last?

The symptoms of pneumococcal sepsis come on suddenly. They include, above all, high fever, reaching even 40 degrees Celsius, coexisting chills or convulsions. The patient's skin turns pale, the heart rate increases and breathing becomes shallow and rapid.

Children who develop pneumococcal sepsis are sleepy and show no interest in their surroundings. They have no appetite, and a looser stool may appear. The child's condition deteriorates rapidly, and may also include:

      • blood coagulation disorders,
      • stopping urination,
      • drop in blood pressure,
      • cool hands and feet,
      • loss of consciousness.

Pneumococcal sepsis - source of infection

Pneumococci (Streptococcus pneumoniae) havealmost all of us - we gain resistance to the bacteria that we are carrying, because our body produces antibodies against them. However, also "our" pneumococci can be dangerous for us - especially in the period of exacerbation of a chronic disease or severe infection. For the environment, "our" pneumococci can also be dangerous. For us, those who are carriers of other people are dangerous.

Two age groups are most susceptible to pneumococcal infections: children under 5 and people over 65; the first is due to the immature, and the second, the not fully functional immune system. In addition, the elderly suffer from chronic diseases that may result in a more severe course of the infection and make treatment more difficult.

Pneumococci are transmitted through direct contact and the droplet path. It is enough for someone in our environment to cough or sneeze and the bacteria will get into our respiratory tract.

The fact that they settle in our airways does not immediately cause sepsis. They typically cause mucosal infections (e.g. sinusitis or otitis media) or asymptomatic carriers that may involve several different types of serological bacteria. Most often, the infection develops as a result of colonization by a new serological type of pneumococcus.

Pneumococcal sepsis can develop only when pneumococcal enter the bloodstream. Invasive pneumococcal infection can also manifest with meningitis, osteitis or purulent arthritis.

Who is most at risk of a pneumococcal attack?

Pneumococcal infections pose the greatest threat to:

  • children under 2,
  • chronically ill people regardless of age (including respiratory and cardiovascular diseases, diabetes, chronic liver disease),
  • people over 65, even if they are he althy,
  • smokers because cigarette smoke damages the epithelium.

Pneumococcal sepsis and other infections

Pneumococci most often cause non-invasive infections. They are limited to the respiratory system. They can cause the inflammation of the middle ear, sinuses or lungs already mentioned. The latter disease especially affects adults. Pneumococci are the main cause of bacterial pneumonia, treatment of which is not always successful - approx. 6%. people die. Mortality in people over 65 years of age increases to 10-20%, and in the case of bacteremia, i.e. the presence of bacteria in the blood - even up to 60%, and increases with age.

Fortunately, invasive infections are much less common, butthey pose a direct threat to life. These are known as invasive pneumococcal disease (IPD), most commonly as bacteremic pneumonia,sepsis, , and meningitis. IChP may also develop, among others as arthritis, endocarditis or peritoneum. In this type of infection, the pneumococci pass through the mucous membranes.

They enter sterile body fluids (eg, blood, cerebrospinal fluid) and tissues and can trigger a systemic reaction to infection. It may lead to multi-organ failure, incl. respiratory and circulatory disorders and, consequently, death. Invasive pneumococcal disease is the greatest risk for toddlers under 2 years of age. It is also very dangerous for children aged 2-5 and people over 65.

Good to know: Blood contamination (bacteremia) is not sepsis. Causes, symptoms and treatment of bacteremia

Worth knowing

Meningococcus and rotavirus are also dangerous

Meningococci and rotaviruses are also dangerous for the he alth of children. Meningococci are the bacteria that cause invasive meningococcal disease with sepsis or meningitis. Of the 5 types of meningococci that cause disease in the world, meningococcus serogroups B and C dominate in Poland and Europe. They cause the majority, because more than 90 percent. Illness. Invasive meningococcal disease is a particular threat to the youngest children - 77% of IPD cases in children under the age of 1 are caused by serogroup B. Meningococci live in the secretions of the nasopharynx. It is estimated that about 5-10 percent. he althy people are unknowingly their carriers. For meningococcal infection to occur, contact with the saliva of the sick person must be made.

Rotaviruses are also very dangerous pathogens that cause acute, watery diarrhea (administered even several times a day), high fever (up to 40 degrees C) and upper respiratory tract infections.

Pneumococcal sepsis. The main symptoms of sepsis

  • high fever (you cannot kill it with antipyretic drugs) or on the contrary - too low body temperature,
  • diarrhea,
  • vomiting,
  • severely increased heart rate (over 90 / minute in adults),
  • pain in limbs,
  • petechiae (- they are not always dark red, but they do not fade under pressure),
  • respiratory rate above 20 / minute (the given value is for adults, in children it is a natural breathing rate).

An important indicator of good peripheral circulation is the time of capillary recovery, i.e. the time after which the pressed, pale tissue returnspink. This is a very simple symptom that is easiest to test on the skin of the sternum.

Other symptoms that suggest sepsis in infants and young children include: oliguria, irritability, excessive sleepiness, breathing difficulties (apnea), rash, skin discoloration (yellowing of the skin, cyanosis, turning pale) and decreased muscle tone.

Pneumococcal sepsis - diagnosis

The test to confirm sepsis is to grow bacteria from a blood culture, but the test usually takes up to 3 days.

A patient with sepsis usually has significantly elevated inflammatory parameters (ESR, CRP, leukocytosis, procalcitonin concentration), decreased platelet count, and impaired heart and kidney function. The initial diagnosis of sepsis, however, is most often based on the experience of a doctor.

Pneumococcal sepsis - prognosis and treatment

Pneumococcal sepsis is not as rapid as meningococcal sepsis and has a lower mortality rate, but is more common and is responsible for more deaths in total than invasive meningococcal infections.

According to official data, about 1,000 people die every year in Poland due to sepsis.

Treatment of sepsis is based on the fastest possible administration of antibiotics, intravenous fluid administration, and life support. It is possible to cure sepsis completely, but keep in mind that complications from a history of sepsis may be permanent.

Pneumococcal sepsis - complications

Complications after sepsis include: necrotic changes in peripheral parts of the body and skin defects. With cerebral hypoxia, coexistence of meningitis or brain abscesses after sepsis, neurological complications may remain, such as epileptic seizures, hearing loss, limb movement paralysis, or various disorders of higher nervous activity (e.g. memory impairment or emotional disorders).