Can pneumococcal pneumonia cause sepsis in a 69-year-old?

Question

Hello doctor,

My 69-year-old mom was admitted to the hospital 10 days ago because of pneumococcal pneumonia, and I am worried about my mom's very slow recovery process. My mom has been at home for four days, but still suffers from a cough with thick green sputum as well as an elevated temperature that rises up to 101°F every day in the evening.

Her recovery is taking longer than expected by the doctors, and she is feeling so weak to the point that even moving from her bedroom to the kitchen exhausts all her energy.

She has been diagnosed with diabetes and COPD, and I understand that these illnesses can have a negative impact on the recovery process, but I am concerned about the time it takes to get better. I know that pneumococcal bacteria can be resistant to some medications, according to what the doctors said at the hospital.

The patient never got vaccinated against pneumonia since she felt perfectly healthy at the time and had no need for the vaccine. My concern now is about my father, who lives with her and who is 72 years old and suffers from heart disease.

Can this situation turn out to be even more serious, resulting in sepsis or meningitis?
Should he get himself checked out?

Kindly advise.

Answer 1

Hello

Welcome to icliniq.com

I understand your concern.

The fact that your mother still has a fever despite being hospitalised for 10 days is alarming and demands more evaluation. There could be various factors that contribute to the delay in recovery; hence, more tests are required to find out the root cause.

I would suggest the following tests, if not done yet:

Complete blood count (CBC).
Sputum gram staining.
Sputum culture and antibiotic sensitivity test.
Blood cultures.

In case there are bacteria that are resistant to antibiotics causing the infection, the cultures from the blood and the sputum, as well as antibiotic susceptibility tests, will help find out the type of bacteria that have caused the infection and the appropriate antibiotics to be used. This will make it possible for the physician treating the infection to use specific antibiotics.

I would suggest getting a consultation with a physician in person or even with an infectious disease expert who will then consider whether there is a need to change the current empiric antibiotics, depending on her condition and culture results. Sometimes, persistence fever may suggest another cause of the infection.

A comprehensive physical exam, in addition to the laboratory findings and repeat chest imaging if needed, will be important prior to the determination of what comes next in her treatment. In light of the data presented, her recovery seems to be taking longer than anticipated and requires an urgent reassessment.

Your father has an elevated risk due to age and heart disease. Nonetheless, pneumococcal pneumonia is not a very contagious illness, even though the bacteria may be transmitted by respiratory droplets. No preventive antibiotics are required unless there are symptoms. It is advisable that the following be done:

Receive the appropriate pneumococcal vaccines if he has not yet taken them.
Annual flu vaccine.
Hand hygiene.
Avoid close contact with respiratory secretions as your mother recovers from her illness.

Finally, a patient receiving antibiotic treatment is usually supposed to display some signs of improvement in 48 to 72 hours. As your mother still exhibits such symptoms as high fever and weakness after 10 days of treatment, there may be some issues that should be considered.

It includes possible antibiotic resistance or complications such as lung abscess, pleural effusion or empyema. This way, we will be able to minimise the chances of developing any complications that include sepsis. Meningitis is a much rarer complication in this case.

I hope this information is helpful. Please feel free to ask if you have any further questions.

Thank you.