Article

Occult pneumococcal bacteremia: a review.

Community Pediatric Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Pediatric emergency care (impact factor: 0.92). 06/2010; 26(6):448-54; quiz 455-7. DOI:10.1097/PEC.0b013e3181e15e36 pp.448-54; quiz 455-7
Source: PubMed

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.

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Keywords

36 months
 
clinical practice
 
current knowledge
 
fascinating phenomenon
 
favor
 
growing consensus
 
Haemophilus influenzae B vaccination
 
historical context
 
intense clinical controversy
 
Occult bacteremia
 
occult pneumococcal bacteremia
 
PCV-7
 
significant problem
 
Streptococcus pneumoniae
 
Vaccine development
 
well-appearing febrile children
 

Mark D Joffe