TAILIEUCHUNG - Chapter 128. Pneumococcal Infections (Part 3)

Specific Infections Caused by S. Pneumoniae S. pneumoniae causes infections of the middle ear, sinuses, trachea, bronchi, and lungs (Table 128-2) by direct spread from the nasopharyngeal site of colonization. Infections of the central nervous system (CNS), heart valves, bones, joints, and peritoneal cavity usually arise by hematogenous spread. Peritoneal infection may also result from ascent via the fallopian tubes. The CNS may also be infected by drainage from nasopharyngeal lymphatics or veins or by contiguous spread of organisms (., through a tear in the dura). Primary pneumococcal bacteremia—., the presence of pneumococci in the blood with no apparent. | Chapter 128. Pneumococcal Infections Part 3 Specific Infections Caused by 5. Pneumoniae S. pneumoniae causes infections of the middle ear sinuses trachea bronchi and lungs Table 128-2 by direct spread from the nasopharyngeal site of colonization. Infections of the central nervous system CNS heart valves bones joints and peritoneal cavity usually arise by hematogenous spread. Peritoneal infection may also result from ascent via the fallopian tubes. The CNS may also be infected by drainage from nasopharyngeal lymphatics or veins or by contiguous spread of organisms . through a tear in the dura . Primary pneumococcal bacteremia . the presence of pneumococci in the blood with no apparent source occurs commonly in children 2 years of age and accounts for a small percentage of all cases of pneumococcal bacteremia in adults if no therapy is given a source and or a secondary site of infection may become apparent. Pleural infection results either from direct extension of pneumonia to the visceral pleura or from hematogenous bacterial spread from a pulmonary or extrapulmonary focus to the pleural space the route usually cannot be determined in any individual case. Infections listed after meningitis in Table 128-2 are uncommon or rare. Table 128-2 Most Common Infections Caused by Streptococcus Pneumoniae in Adults Site Infections Respiratory tract Otitis media Acute sinusitis Tracheobronchitis Pneumonia Empyema Central nervous system Meningitis Brain abscess Cardiac Endocarditis Pericarditis Soft tissue skeletal Septic arthritis Osteomyelitis Cellulitis Other Peritonitis Endometritis Primary bacteremia Otitis Media and Sinusitis Otitis media and acute rhinosinusitis are similar in terms of pathogenesis. Bacteria are trapped in a normally sterile site when drainage is impaired often as a result of viral infection allergies or exposure to pollutants including cigarette smoke . In both disease states S. pneumoniae is the most common or second .

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