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Pneumococcal pneumonia (EPIDEMIOLOGY (Incidence (large proportion of lobar…
Pneumococcal pneumonia
EPIDEMIOLOGY
Incidence
large proportion of lobar pneumonias
50% lobar pneumonias
males
30-50 years
winter & early spring
40% mortality sans treatment (vaccine available)
BACTERIOLOGY
gram + diplococcus
80 types with Ag diffs. in capsular polysaccharide
Types 1, 2, 3 cause lobar pneumonia
All types can cause bronchopneumonia
capsule prevents phagocytosis if not specific Ab
MORPHOLOGY
commensal in nose
aspirated into alveoli
++ exudate involving hypersensitivty
RISK FACTORS
Splenectomy
Spleen NB for producing Abs against capsulated Ags
sickle cell disease
smoking
asthma, COPD
haematological disease