Streptococcal pneumonia: causes, symptoms, diagnosis, treatment

Streptococcal pneumonia is rare. It can be caused as beta-hemolytic streptococcus group A, and other types of streptococci. Usually streptococcal pneumonia develops as a complication of influenza, measles, chicken pox, whooping cough.

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Symptoms of Streptococcal Pneumonia

Streptococcal pneumonia begins acutely, it is quite hard. As a rule, suddenly there is a fever, shortness of breath, coughing, chest pain. Cough is initially dry, then mucopurulent sputum appears, sometimes it contains an admixture of blood. Thus, the onset of streptococcal pneumonia often resembles pneumococcal pneumonia, but unlike the latter, chills are rarely observed.

Percutaneous and auscultatory symptoms are not always clearly expressed due to the fact that the pneumonia foci are small, they are more often localized in the lower and middle sections of the lungs. Initially, one segment is affected, then the inflammatory process spreads quickly, possibly the development of multiple foci of inflammation, which can merge and give a picture reminiscent of shared pneumonia (pseudolobular pneumonia).

An extremely characteristic feature of streptococcal pneumonia is the development of exudative pleurisy with purulent exudate (empyema of the pleura). His symptoms may appear as early as 2-3 days of the disease. Possibility of abscessing of pneumonic foci.

Stetococcal pneumonia is also characterized by high leukocytosis (up to 20-30 x 10 ⁹ / l) with a pronounced shift of the leukocyte formula to the left.

X-ray examination of the lungs reveals a multitude of small, sometimes merging foci, possibly affecting the lobe of the lung with the formation of an abscess (a cavity with a horizontal liquid level). With the development of pleural empyema, there is an intense homogeneous darkening with an oblique upper level.

With pleural puncture, you can get a purulent fluid, less often serous or serous-hemorrhagic.

Diagnosis of streptococcal pneumonia

Streptococcal pneumonia is diagnosed on the basis of the following provisions:

• the development of pneumonia during or after suffering measles, chicken pox, whooping cough, flu, scarlet fever, strep throat;
• acute onset of pneumonia;
• the appearance already at an early stage of pneumonia exudative pleurisy (especially empyema of the pleura);
• detection of Gram-stained sputum in smears of Gram-positive cocci chains that differ from Str.pneumoniae in their non-lanceolate form and negative reaction of swelling of the capsule after the addition of the polyvalent pneumococcal antiserum; JG Varlett (1997) indicates that beta-hemolytic streptococci of A troupe are similar to alpha-hemolytic streptococci, related to the normal microflora of the oral cavity, so streptococci found in sputum should be typed according to Lansfidd. The most common pneumonia is caused by beta-hemolytic streptococci in group A;
• the growth of anti-streptolysin-0 titres in the patient's blood in dynamics.

[4], [5], [6], [7], [8]

Treatment of streptococcal pneumonia

It is treated the same way as pneumococcal pneumonia. A rare form of streptococcal pneumonia caused by Str. Faecalys, requires the appointment of penicillins of a wide spectrum of action (ampicillin, amoxicillin, etc.). In the presence of resistance or allergy to penicillin, vancomycin or its combination with aminoglycosides is indicated.

Vancomycin is administered intravenously in an isotonic solution of sodium chloride or 5% glucose solution at a concentration of 2.5-5 mg / ml (dropwise for 20-40 minutes). Assign 0.5-1 g every 12 hours.

• Pneumonia - Treatment regimen and nutrition
• Antibacterial drugs for the treatment of pneumonia
• Pathogenetic treatment of pneumonia
• Symptomatic treatment of pneumonia
• Fighting complications of acute pneumonia
• Physiotherapy, exercise therapy, respiratory gymnastics with pneumonia
• Sanatorium treatment and rehabilitation for pneumonia

Highly effective treatment with glycopeptide - teicoplant intramuscularly and intravenously at 3-6 mg / kg per day (for 1-2 injections).