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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.


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 covering of the brain and spinal cord. Symptoms include:

  • Stiff neck
  • Fever
  • Headache
  • Pain when looking into bright lights
  • Confusion

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

Pneumococcal bacteremia and sepsis are blood infections. Symptoms include:

  • Fever
  • Chills
  • Low alertness

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

  • Ear pain
  • A red, swollen ear drum
  • Fever
  • Sleepiness
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Some pneumococcal infections are considered “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 and others may have long-term problems, such as hearing loss or developmental delay. The chance of death increases among elderly patients.

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 blood stream infection die of it. The chance of death increases 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), and blockage of the airway that allows air into the lungs (endobronchial obstruction), with lung collapse (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. Pneumococcal pneumonia is considered non-invasive if there’s not bacteremia or empyema occurring at the same time.

Sinus and ear infections are usually mild and are much 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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