Symptoms and Complications

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There are many types of pneumococcal disease. Symptoms and complications depend on the part of the body that is infected.

Symptoms

Pneumococcal pneumonia (lung infection) is the most common serious form of pneumococcal disease. Symptoms include:

  • Fever and chills
  • Cough
  • Rapid breathing or difficulty breathing
  • Chest pain
mother checking baby for fever

Older adults with pneumococcal pneumonia may experience confusion or low alertness, rather than the more common symptoms listed above.

Pneumococcal meningitis is an infection of the tissue covering the brain and spinal cord. Symptoms include:

  • Stiff neck
  • Fever
  • Headache
  • Photophobia (eyes being more sensitive to light)
  • Confusion

In babies, meningitis may cause poor eating and drinking, low alertness, and vomiting.

Pneumococcal bacteremia is a blood infection. Symptoms include:

  • Fever
  • Chills
  • Low alertness

Sepsis is a complication caused by the body’s overwhelming and life-threatening response to an infection, which can lead to tissue damage, organ failure, and death. Symptoms include:

  • Confusion or disorientation
  • Shortness of breath
  • High heart rate
  • Fever, shivering, or feeling very cold
  • Extreme pain or discomfort
  • Clammy or sweaty skin

Pneumococcus bacteria cause up to half of middle ear infections (otitis media). Symptoms include:

  • Ear pain
  • A red, swollen ear drum
  • Fever
  • Sleepiness

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Complications

Doctors consider some pneumococcal infections to be “invasive.” Invasive disease means that germs invade parts of the body that are normally free from germs.

Most pneumococcal infections are mild. However, some can be deadly or result in long-term problems, such as brain damage or hearing loss.

Meningitis is the most severe type of invasive pneumococcal disease. Of children younger than 5 years old who get pneumococcal meningitis, about 1 out of 15 dies of the infection. The chance of death from pneumococcal meningitis is higher among elderly patients. Others may have long-term problems, such as hearing loss or developmental delay.

Bacteremia is a type of invasive pneumococcal disease that infects the blood. About 1 out of 100 children younger than 5 years old with this bloodstream infection die of it. The chance of death from pneumococcal bacteremia is higher among elderly patients.

Pneumonia is an infection of the lungs that can cause mild to severe illness in people of all ages. Complications of pneumococcal pneumonia include

  • Infection of the space between membranes that surround the lungs and chest cavity (empyema)
  • Inflammation of the sac surrounding the heart (pericarditis)
  • Blockage of the airway that allows air into the lungs (endobronchial obstruction), with collapse within the lungs (atelectasis) and collection of pus (abscess) in the lungs

About 5 out of 100 people with non-invasive pneumococcal pneumonia will die from it, but that rate may be higher among elderly patients. Doctors consider pneumococcal pneumonia non-invasive if there’s not bacteremia or empyema occurring at the same time.

Sinus and ear infections are usually mild and are more common than the more severe forms of pneumococcal disease. However, some children develop repeated ear infections and may need ear tubes.

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Page last reviewed: September 6, 2017