1. YASHWANT KUMAR
GROUP 8

2. INTRODUCTION
 THE PNEUMOCOCCUS IS AN ENCAPSULATED
GRAM POSITIVE COCCUS.
 ELONGATED OR “LANCET-SHAPED”,ARRANGED
IN PAIRS (DIPLOCOCCI) AND SHORT CHAINS.
 IT IS COVERED WITH POLYSACCHARIDE CAPSULE
AND THEIR CELL WALL COMPONENT OF THE
CELL IS TEICHOIC ACID AND PEPTIDOGLYCAN
LAYER.
 ITS ALSO CONTAINS CRP,PHOSPHOCHOLINE AND
AMIDASE.

3. VIRULENCE
 IT IS DETERMINED BY ABILITY TO COLONIZE
OROPHARNX BY SURFACE PROTEIN ADHESIONS.
 SPREAD INTO NORMALLY STERILE TISSUES BY
PNEUMOLYSIN,IGA PROTEASE.
 STIMULATE LOCAL INFLAMMATORY RESPONSE
BY TEICHOIC ACID,PEPTIDOGLYCAN
FRAGMENTS,AMIDASE,PNEUMOLYSIN
 HYDROGEN PER OXIDE ,LEADS TO TISSUE
DAMAGE AND PHOSPHOCHOLINE ,PROTECTED
FROM OPSONISATION AND PHAGOCYTOSIS.
 EVADE PHAGOCYTIC KILLING
(POLYSACCHARIDE CAPSULE)

4. DISEASE
 PNENMONIA.(IN MOST OF THE CASES)
 SINUSITIS AND OTITIS MEDIA.
 MENINGITIS.
 BACTEREMIA.
 PERICARDITIS AND ENDOCARDITIS
 SEPSIS.
 OSTEOMYELETIS.
 PERITONITIS AND BRAIN ABSCESS.

5. MAIN SYMPTOMS OF INFECTION

6. CAUSES
 1. Cerebral palsy
 2. Chronic lung disease
(COPD, bronchiectasis, cystic fibrosis)
 3. Cigarette smoking
 4. Difficulty swallowing (due
to stroke, dementia, Parkinson's disease,
or other neurological conditions)
 5. Immune system problem ( Pneumonia
in immuno-compromised host)
 6. Impaired consciousness (loss of brain
function due to dementia, stroke, or other
neurologic conditions)
 7. Living in nursing facility
 8. Other serious illnesses, such as heart
disease, liver cirrhosis, or diabetes
mellitus
 9. Recent surgery or trauma
 10. Recent cold, laryngitis, or flu

7. EDIDERMIOLOGY
 MOST INFECTIONS ARE CAUSED BY ENDOGENOUS SPREAD
FROM THE COLONIZED NASOPHARYNX OR OROPHARYNX TO
DISTAL SITE(EG;LUNGS,SINUS,EARS,BLOOD,MENINGES)
 COLONIZATION IS HIGHEST IN CHILDREN .
 INDUVIDUALS WITH ANTECEDENT VIRAL RESPIRATORY
TRACT DISEASE OR OTHER CONDITIONS THAT INTERFERE
WITH BACTERIAL CLEARANCE FROM RESPIRATORY TRACT
ARE INCREASED RISK FOR PULMONARY DISEASE.
 CHILDREN AND ELDERLY PEOPLE ARE AT GREATER RISK OF
MENINGITIS.
 PEOPLE WITH HEMATOLOGIC
DISORDER(EG;MALIGNANCY,SICKLE CELL DISEASE) OR
FUNCTIONAL ASPLENIA ARE AT RISK FOR FULMINANT SEPSIS
 ORGANISM IS UBIQUITOUS ,DISEASE IS MORE COMMON IN
COOL MONTHS.
 PERSON-TO-PERSON SPREAD THROUGH INFECTIOUS
DROPLETS IS RARE.

8. Diagnosis :
Physical
Examination Lab testing
PHYSICAL EXAMINATION :
 CHEST X-RAY
 CRACKLINGS VIA STETHOSCOPE
 INCREASED RESPIRATORY RATE
(children) , COUGH, PERTUSIS.

9. LABORATORY DIAGNOSIS
 MICROSCOPY IS HIGHLY SENSITIVE,AS IS CULTURE,
UNLESS THE PATIENT HAS BEEN TREATED WITH
ANTIBIOTICS.
 ANTIGEN TEST FOR PNEUMOCOCCAL C POLYSACCHARIDE
IS SENSITIVE WITH CSF (MENINGITIS) .
 NUCLEIC-ACID –BASED TESTS .
 CULTURE REQUIRES USE OGF ENRICHED-NUTRIENT
MEDIA(EG;SHEEP BLOOD AGAR),ORGANISM HIGHLY
SUSCEPTIBLE TO MANY ANTIBIOTICS, SO CULTURE CAN BE
NEGATIVE IN PARTIALLY TREATED PATIENTS.
 ISOLATES IDENTIFIED BY CATALASE (NEGATIVE),
SUSCEPTIBILTY TO OPTOCHIN,AND SOLUBILTY IN BILE.

10. TREATMENT
 PENICILLIN IS THE DRUG OF CHOICE FOR
SUSCEPTIBLE STRAINS ,ALTHOUGH RESISTANCE IS
INCREASINGLY COMMON.
 FLUOROQUINOLONE OR VANCOMYCIN COMBINED
WITH CEFTRIAXONE IS USED IN PATIENTS ALLERGIC
TO PENCILLIN OR PENCILLIN RESISTANCE STRAINS.
 IMMUNIZATION WITH 7-VALENT CONJUGATED
VACCINE IS RECOMMENDED FOR CHILDRENS UNDER
2 YEARS, A 23-VALENT POLYSACCHARIDE VACCINE IS
RECOMMENDED FOR ADULTS AT RISK FOR DISEASE.
 OTHER ANTIBIOTIC DRUGS USED ARE
AMOXILLIN,TETRACYCLINES,ERYTHROMYCIN,
AZITHOMYCIN,CLARITHROMYCIN.

12. Prevention and
control :
 60 % pneumonia is bacterial origin
 Vaccination :
Pneumonococcal
vaccines
 Maintaining immuno competancy
 To be cautious about cold and flu’s
 No self medication

13. THANK
YOU
FOR LISTENTING