Infectious Diseases

Symptoms and Treatment of Pneumococcal Pneumonia

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Pneumonia is a serious medical condition where the lung's alveoli become inflamed, or where part or all of the lungs fill with fluid. Pneumococcal pneumonia is a form of bacterial pneumonia most commonly caused either by the Gram-positive bacterium Streptococcus pneumoniae or by the Gram-positive bacterium Staphylococcus aureus.

S. pneumoniae is the most common bacterial cause of pneumonia in all age groups, with the exception of newborn infants. This form of pneumococcal pneumonia is especially common among young children and the elderly, particularly after a previous flu infection.

About 1/3 of all people carry S. aureus harmlessly in the nose or throat. Pneumococcal pneumonia caused by S. aureus is usually a complication of a penetrating staph infection after tissue barriers have been breached.


The most common symptoms of pneumococcal pneumonia are fever, cough, and shortness of breath due to fluid in the lungs. Other symptoms may include chills and sharp chest pain associated with breathing. In extreme cases, pneumococcal pneumonia is also marked by coughing up blood.

Because pneumococcal pneumonia frequently follows the flu, the early symptoms of pneumococcal pneumonia may be confused with flu symptoms. Some symptoms may also be masked by use of anti-fever or anti-cough medications.


Standard treatment of pneumococcal pneumonia is with oral antibiotics to fight the underlying bacterial infection, fluids, rest, and home care. Antibiotics may be supplemented by fever or cough medication to alleviate symptoms. Although fever or cough medication by itself does not improve outcomes, hydrocodone for cough may indirectly help outcomes where coughing is so severe that it interferes with sleep.

Amoxicillin is the first choice of antibiotic, although erythromycin or azithromycin may also be prescribed, depending on the age and underlying health of the patient and how the infection was acquired. The duration of antibiotic treatment is 7-10 days. However, shorter durations of 3-5 days may be equally effective.

Hospital-acquired pneumococcal pneumonia is often caused by antibiotic-resistant bacteria. It is commonly treated by 3rd- and 4th-generation intravenous antibiotics, and may also require extra oxygen or even a ventilator to assist breathing until the antibiotics and immune system can fight off the infection.

In most cases, pneumococcal pneumonia does not require hospitalization. With appropriate treatment and home care, most cases of pneumococcal pneumonia clear up in between 2 and 4 weeks.


A vaccine is available against S. pneumoniae. PCV 7 pneumococcal conjugate vaccine is recommended for all children under 2 years of age, as well as older children who are at higher risk for pneumonia. For seniors and other at-risk adults, pneumococcal polysaccharide vaccine is recommended. Neither form gives protection against all serotypes of S. pneumoniae.

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