Occult pneumococcal bacteremia: a review

Pediatr Emerg Care. 2010 Jun;26(6):448-54; quiz 455-7. doi: 10.1097/PEC.0b013e3181e15e36.

Abstract

Occult bacteremia is primarily caused by Streptococcus pneumoniae and has been an intense clinical controversy in pediatric emergency medicine, with passionate opinions rendered from inside and outside the field. Vaccine development and widespread immunization have rapidly affected the changing epidemiology of this disease. There is a growing consensus that the reduction in incidence of occult bacteremia and the significant problem of antibiotic resistance are tipping the balance in favor of no testing and no treatment for well-appearing febrile children between 6 and 36 months of age who are immunized with Haemophilus influenzae B vaccination and PCV-7 (pneumococcal conjugate vaccine). This review of occult pneumococcal bacteremia will not only elaborate on current knowledge and clinical practice, but will also provide historical context to this fascinating phenomenon.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / diagnosis
  • Bacteremia / microbiology*
  • Bacteremia / prevention & control
  • Bacteremia / therapy*
  • Child, Preschool
  • Decision Support Techniques
  • Diagnosis, Differential
  • Drug Resistance, Bacterial
  • Humans
  • Infant
  • Pneumococcal Infections / diagnosis
  • Pneumococcal Infections / prevention & control
  • Pneumococcal Infections / therapy*
  • Pneumococcal Vaccines / therapeutic use
  • Risk Factors

Substances

  • Anti-Bacterial Agents
  • Pneumococcal Vaccines