Which physical findings are characteristic of pediatric pneumococcal infections?

Updated: Jan 14, 2019
  • Author: Meera Varman, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Physical findings include the following:

  • OM – Bulging, erythematous, or yellow tympanic membrane with poor mobility and purulent fluid seen behind the membrane

  • Sinusitis – Tenderness to palpation over maxillary or frontal sinuses, nasal discharge of any color, swollen nasal turbinates

  • Bacteremia – None, besides fever (≥102°F) and tachycardia associated with the fever

  • Pneumonia – Crackles or decreased breath sounds in the area of lobar consolidation on chest auscultation, with egophony in patients with severe consolidation and dullness to percussion; retractions, tachypnea, or both

  • Meningitis or other central nervous system (CNS) infection – Ill appearance; nuchal rigidity (may not be present before age 4 months); altered mental status with poor responsiveness (patient may present in comatose state); other neurologic abnormalities possible (eg, cranial nerve deficits, ataxia, weakness); poor perfusion and signs of shock in patients with concurrent pneumococcal sepsis

See Presentation for more detail.


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