Nelson - Ch. 182 S. pneumoniae Flashcards
Hemolysis pattern of S. pneumoniae
Alpha
T/F S. pneumoniae: Bile soluble
T
T/F S. pneumoniae: Optochin sensitive
T
Reaction that demonstrates the capsule of S. pneumoniae
Quellung
T/F Conjugated PCV protect against pneumococcal colonization
T
T/F Pneumococcal polysaccharide vaccine protects against pneumococcal colonization
F
Rates of pneumococcal carriage peak when
1st and 2nd year of life
MC cause of bacteremia, bacterial pneumoniae, otitis media, and bacterial meningitis in children
S. pneumoniae
Children at increased risk of pneumococcal infections
1) Sickle cell disease 2) Asplenia 3) Humoral (B cell) and complement-mediated immunodeficiency 4) HIV infection 5) Certain malignancies 6) Chronic heart, lung, or renal disease 7) CSF leak 8) Cochlear implants
T/F Males are at increased risk for invasive pneumococcal infections than females
T
An important cause of secondary bacterial pneumonia in patients with influenza
S. pneumoniae
Invasive pneumococcal infection is highest in what age group
Less than 2, antibody production to most pneumococcal serotypes is poor
Increased frequency of pneumococcal disease in asplenic persons is related to
1) Deficient opsonization 2) Absence of clearance by the spleen of circulating bacteria
Children with sickle cell disease have increased frequency of pneumococcal disease because
1) Deficit in antibody-INDEPENDENT properdin (alternative) pathway of complement activation 2) Functional asplenia
T/F With advancing age, children with sickle cell disease produce anti capsular antibody, augmenting antibody-dependent opsonophagocytosis and greatly reducing the risk of severe pneumococcal disease
T
Immunodeficiency associated with recurrent pyogenic infection
Complement
T/F Cultures of nose and throat is helpful for diagnosis of pneumococcal infection in cases of otitis media, pneumonia, and septicemia or meningitis
F
Average time to isolation of pneumococcal organisms
14-15hrs
Children 1 month of age or older with suspected pneumococcal meningitis should be treated with
Vancomycin (60mkday q6) and high-dose Cefotaxime (300mkday q8) or Ceftriaxone (100mkday q12)
Penicillin-susceptible pneumococcal meningitis can be treated with
1) Penicillin or 2) Cefotaxime or Ceftriaxone
Penicillin-, cefotaxime- and ceftriaxone-resistant pneumococcal meningitis should be treated with
Vanco + Ceftri or Cefotax, consider adding Rifampin
First-line therapy for PCAP in previously healthy, appropriately immunized infants and preschool children with mild to moderate uncomplicated PCAP
Amoxicillin (outpatient), Ampicillin or Pen G (if admitted)
First-line therapy for PCAP in not fully immunized infants and preschool children with mild to moderate uncomplicated PCAP
3rd gen Cephalosporin
First-line therapy for PCAP in not fully immunized infants and preschool children with life-threatening pneumococcal infection
3rd gen Cephalosporin
Alternatives to penicillin in patients with pneumococcal infection with penicillin allergy
1) Clindamycin 2) Erythromycin 3) Cephalosporins 4) TMP-SMX
Treatment for otitis media caused by penicillin-resistant strep
Amoxicillin, high dose (80-100mkday)
The mortality rate for pneumococcal meningitis is approximately
10%
T/F Pneumococcal meningitis results in sensorineural hearing loss
T
T/F Pneumococcal meningitis can cause serious neurologic sequelae such as paralysis, epilepsy, blindness, and intellectual deificits
T
Pneumococcal prophylaxis in sickle cell disease has been safely discontinued after ___ birthday in children who have received all recommended pneumococcal vaccine doses and who had not experienced invasive pneumococcal disease
5th
When is pneumococcal prophylaxis given for children who have undergone splenectomy
2 years after splenectomy up to 5 years of age
