PNEUMOCOCCAL BACTEREMIA - A CONTINUING CHALLENGE

Abstract

In a retroscpective study of pneumococcal bacteremia in a large district hospital over an 8 yr period, 103 cases were identified. Although all age groups were represented, an unexpectedly large number of cases occurred among elderly males. The overall case fatality rate was 34%, ranging from 13% in children to 42% in the elderly. Most children seem to have been healthy before the infection and did not have pneumonia. Most adults had preexisting disease and did have pneumonia. Pre-existing diseases were of 3 main types: disorders of the respiratory system; disorders of metabolism; and disorders of the immune system. Six patients had no spleen. Almost all patients received appropriate antibiotics. Most deaths occurred during the first 48 h of treatment. The prospects for the prevention of fatal pneumococcal bacteremia are reviewed in the light of these findings.