Educational resource · Not a medical device · Infectious diseases review in progress · Does not replace clinical judgement

Streptococcus pneumoniae — Pneumococcus

Review by an infectious diseases specialist in progress · edited by a physician, AI-assisted writing · level of evidence computed from the source type · page as of 10 November 2026 · Methodology

Streptococcaceae · Gram-positive

1ère cause de pneumopathie bactérienne communautaire sévère et de méningite bactérienne de l'adulte en France. Toute bactériémie à pneumocoque nécessite la recherche d'un foyer pulmonaire, méningé ou ORL. Antigénurie urinaire pneumocoque : sensibilité 50-80 %, spécificité > 90 % chez l'adulte (Mandell 2007). Méningite : dexaméthasone, duration not verified, AVANT ou avec la 1ère dose d'ATB (non recommandée chez l'immunodéprimé ni en cas de listériose cérébro-méningée ; chez l'enfant, indiquée si la microbiologie initiale du LCS évoque l'H. influenzae (BGN à l'examen direct) ou le pneumocoque ; SPILF 2019), est associée à moins de surdité et de séquelles neurologiques, et à une mortalité plus basse dans le sous-groupe pneumocoque (Brouwer 2010, Cochrane : RR 0,84) — see cited source. Splénectomie/asplénie fonctionnelle (drépanocytose) : risque d'infection fulminante (OPSI) très augmenté — antibiothérapie préemptive et vaccination recommandées.

Scope: dosing as described in the cited guidelines (French or international context, stated by the source), for adults with normal renal function unless stated on the line. No renal or hepatic, paediatric or pregnancy adjustment is provided systematically. These regimens have not been reviewed by any infectious-disease specialist to date.

Documented organ tropism

Organs where foci of Streptococcus pneumoniae are described in the cited literature. The reported frequency is not an individual probability.

Organ	Tropism	Level of evidence	Sources	Spread route
Lung	High tropism	Evidence B	3	not recorded
Ear (otite moyenne aiguë)	High tropism	Evidence B	4	not recorded
Heart / Endocardium	Rare tropism	Evidence B	2	not recorded
Meninges	High tropism	Evidence A	4	hematogenous
Pleura	Moderate tropism	Evidence B	2	contiguous
Paranasal sinuses (rhinosinusite bactérienne)	Moderate tropism	Evidence B	2	contiguous

Described portals of entry

• Lung
• Ear

Described spread path

Nasopharynx (portage) → inhalation → poumon (pneumonie) OU voie ascendante (OMA, sinusite) OU bactériémie → méninges (méningite)

Spread routes recorded: 3 of 6 documented foci A focus without a route is not a focus without spread: the route is simply not recorded.

Associated syndromes

• Bacterial meningitis
• Community-acquired pneumonia (CAP)
• Bacteraemia and sepsis
• Bacterial peritonitis

Sources

• Mandell LA et al. — IDSA/ATS CAP Consensus Guidelines (CID) (2007) — doi:10.1086/511159
• Metlay JP et al. — Diagnosis and Treatment of Adults with Community-acquired Pneumonia: ATS/IDSA Clinical Practice Guideline (Am J Respir Crit Care Med) (2019) — doi:10.1164/rccm.201908-1581ST
• Fine MJ et al. — Prediction rule to identify low-risk patients with CAP (NEJM) (1997) — doi:10.1056/NEJM199701233360402
• SPILF — Antibiotherapie par voie generale en pratique courante : infections ORL et respiratoires basses de l'adulte et de l'enfant (2011) — https://www.infectiologie.com/
• Lieberthal AS et al. — AAP/AAFP Acute Otitis Media Guidelines (Pediatrics) (2013) — doi:10.1542/peds.2012-3488
• Austrian R — Pneumococcal endocarditis, meningitis, and rupture of the aortic valve (AMA Arch Intern Med) (1957) — doi:10.1001/archinte.1957.00260040039004
• ESC Guidelines for the management of endocarditis (Delgado V et al.) (2023) — doi:10.1093/eurheartj/ehad193
• Brouwer MC et al. — Corticosteroids for acute bacterial meningitis (2010) — doi:10.1002/14651858.CD004405.pub3
• van de Beek D et al. — Community-acquired bacterial meningitis in adults (NEJM) (2004) — doi:10.1056/NEJMoa040845
• SPILF — Info-antibio n° 90 (août 2019) : Méningites bactériennes communautaires, recommandations 2018 (synthèse) (2019) — https://www.infectiologie.com/UserFiles/File/spilf/atb/info-antibio/info-antibio-2019-08-meningite.pdf
• SPILF — Prise en charge des méningites aiguës communautaires : actualisation 2018 des recommandations (X. Duval, 19es JNI, Nantes, juin 2018), diaporama (2018) — https://www.infectiologie.com/UserFiles/File/jni/2018/com/jni2018-reco-meningite-x-duval.pdf
• Hooper C et al. — Investigation of a unilateral pleural effusion in adults: BTS Pleural Disease Guideline 2010 (Thorax) (2010) — doi:10.1136/thx.2010.136978
• Roberts ME et al. — British Thoracic Society Guideline for pleural disease (Thorax) (2023) — doi:10.1136/thorax-2022-219784
• SPILF/GPIP — Rhinosinusites aiguës de l'adulte et de l'enfant (2021) — https://www.infectiologie.com/
• Chow AW et al. — IDSA Clinical Practice Guideline for Acute Bacterial Rhinosinusitis (CID) (2012) — doi:10.1093/cid/cir1043

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