Skip to main content
PMC home page
British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1983 Jan 15;286(6360):203–206. doi: 10.1136/bmj.286.6360.203

Occult pneumococcal bacteraemia and febrile convulsions.

P McIntyre, R Kennedy, F Harris
PMCID: PMC1546294  PMID: 6401529

Abstract

Over two years 29 children had bacteraemia due to Streptococcus pneumoniae at this hospital. In 15 previously healthy children the site of infection could not be identified, and in most of them, bacteraemia was not suspected clinically. All 15 had high total white cell (greater than or equal to 17 x 10(9)/1) and neutrophil (greater than or equal to 11 x 10(9)/1) counts. Twelve children were under 4 years of age, and of these, 10 had been admitted because of a simple febrile convulsion and one had a prolonged febrile convulsion. Occult pneumococcal bacteraemia has been reported in the USA for more than 10 years, but no series has been reported from the United Kingdom. Occult pneumococcal bacteraemia may be an important cause of febrile convulsions. Persisting bacteraemia and the development of focal infections, including pneumococcal meningitis, have been reported. Meningitis did not occur after occult bacteraemia in our patients. Studies to date have been retrospective, and thus the true incidence of the complications and the best treatment are not clear. A prospective study of children with febrile convulsions could provide answers.

Full text

PDF
203

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aärimaa T., Peltola H., Ruuskanen O. Pneumococcaemia complicated by meningitis. Arch Dis Child. 1982 May;57(5):392–394. doi: 10.1136/adc.57.5.392. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Baron M. A., Fink H. D. Bacteremia in private pediatric practice. Pediatrics. 1980 Aug;66(2):171–175. [PubMed] [Google Scholar]
  3. Belsey M. A. Pneumococcal bacteremia. A report of three cases. Am J Dis Child. 1967 May;113(5):588–589. doi: 10.1001/archpedi.1967.02090200120015. [DOI] [PubMed] [Google Scholar]
  4. Bratton L., Teele D. W., Klein J. O. Outcome of unsuspected pneumococcemia in children not initially admitted to the hospital. J Pediatr. 1977 May;90(5):703–706. doi: 10.1016/s0022-3476(77)81231-6. [DOI] [PubMed] [Google Scholar]
  5. Burke J. P., Klein J. O., Gezon H. M., Finland M. Pneumococcal bacteremia. Review of 111 cases, 1957--1969, with special reference to cases with undetermined focus. Am J Dis Child. 1971 Apr;121(4):353–359. [PubMed] [Google Scholar]
  6. Feder H. M., Jr Occult pneumococcal bacteremia and the febrile infant and young child. Clin Pediatr (Phila) 1980 Jul;19(7):457–462. doi: 10.1177/000992288001900705. [DOI] [PubMed] [Google Scholar]
  7. Fischer G. W., Brenz R. W., Alden E. R., Beckwith J. B. Lumbar punctures and meningitis. Am J Dis Child. 1975 May;129(5):590–592. doi: 10.1001/archpedi.1975.02120420038014. [DOI] [PubMed] [Google Scholar]
  8. Hamrick H. J., Murphy T. F. Bacteremia in 28 ambulatory children: relationship to pneumonitis and meningitis. Clin Pediatr (Phila) 1978 Feb;17(2):109–112. doi: 10.1177/000992287801700202. [DOI] [PubMed] [Google Scholar]
  9. Heldrich F. J., Jr Diplococcus pneumoniae bacteremia. Am J Dis Child. 1970 Jan;119(1):12–17. doi: 10.1001/archpedi.1970.02100050014005. [DOI] [PubMed] [Google Scholar]
  10. Jaffe M., Bar-Joseph G., Tirosh E. Fever and convulsions--indications for laboratory investigations. Pediatrics. 1981 May;67(5):729–731. [PubMed] [Google Scholar]
  11. Loda F. A., Collier A. M., Glezen W. P., Strangert K., Clyde W. A., Jr, Denny F. W. Occurrence of Diplococcus pneumoniae in the upper respiratory tract of children. J Pediatr. 1975 Dec;87(6 Pt 2):1087–1093. doi: 10.1016/s0022-3476(75)80120-x. [DOI] [PubMed] [Google Scholar]
  12. McCarthy P. L., Dolan T. F., Jr Hyperpyrexia in children. Eight-year emergency room experience. Am J Dis Child. 1976 Aug;130(8):849–851. doi: 10.1001/archpedi.1976.02120090059010. [DOI] [PubMed] [Google Scholar]
  13. McCarthy P. L., Grundy G. W., Spiesel S. Z., Dolan T. F., Jr Bacteremia in children: an outpatient clinical review. Pediatrics. 1976 Jun;57(6):861–868. [PubMed] [Google Scholar]
  14. McCarthy P. L., Jekel J. F., Dolan T. F., Jr Temperature greater than or equal to 40 C in children less than 24 months of age: a prospective study. Pediatrics. 1977 May;59(5):663–668. [PubMed] [Google Scholar]
  15. McGowan J. E., Jr, Bratton L., Klein J. O., Finland M. Bacteremia in febrile children seen in a "walk-in" pediatric clinic. N Engl J Med. 1973 Jun 21;288(25):1309–1312. doi: 10.1056/NEJM197306212882501. [DOI] [PubMed] [Google Scholar]
  16. McGowan J. E., Jr, Bratton L., Klein J. O., Finland M. Bacteremia in febrile children seen in a "walk-in" pediatric clinic. N Engl J Med. 1973 Jun 21;288(25):1309–1312. doi: 10.1056/NEJM197306212882501. [DOI] [PubMed] [Google Scholar]
  17. Myers M. G., Wright P. F., Smith A. L., Smith D. H. Complications of occult pneumococcal bacteremia in children. J Pediatr. 1974 May;84(5):656–660. doi: 10.1016/s0022-3476(74)80005-3. [DOI] [PubMed] [Google Scholar]
  18. PETERSDORF R. G., SWARNER D. R., GARCIA M. Studies on the pathogenesis of meningitis. II. Development of meningitis during pneumococcal bacteremia. J Clin Invest. 1962 Feb;41:320–327. doi: 10.1172/JCI104485. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Rutter N., Smales O. R. Role of routine investigations in children presenting with their first febrile convulsion. Arch Dis Child. 1977 Mar;52(3):188–191. doi: 10.1136/adc.52.3.188. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Santosham M., Moxon E. R. Detection and quantitation of bacteremia in childhood. J Pediatr. 1977 Nov;91(5):719–721. doi: 10.1016/s0022-3476(77)81022-6. [DOI] [PubMed] [Google Scholar]
  21. Sullivan T. D., LaScolea L. J., Jr, Neter E. Relationship between the magnitude of bacteremia in children and the clinical disease. Pediatrics. 1982 Jun;69(6):699–702. [PubMed] [Google Scholar]
  22. Teele D. W., Dashefsky B., Rakusan T., Klein J. O. Meningitis after lumbar puncture in children with bacteremia. N Engl J Med. 1981 Oct 29;305(18):1079–1081. doi: 10.1056/NEJM198110293051810. [DOI] [PubMed] [Google Scholar]
  23. Teele D. W., Marshall R., Klein J. O. Unsuspected bacteremia in young children: a common and important problem. Pediatr Clin North Am. 1979 Nov;26(4):773–784. doi: 10.1016/s0031-3955(16)33783-x. [DOI] [PubMed] [Google Scholar]
  24. Todd J. K. Childhood infections. Diagnostic value of peripheral white blood cell and differential cell counts. Am J Dis Child. 1974 Jun;127(6):810–816. doi: 10.1001/archpedi.1974.02110250036005. [DOI] [PubMed] [Google Scholar]
  25. Torphy D. E., Ray C. G. Occult pneumococcal bacteremia. Am J Dis Child. 1970 Apr;119(4):336–338. doi: 10.1001/archpedi.1970.02100050338010. [DOI] [PubMed] [Google Scholar]
  26. Waskerwitz S., Berkelhamer J. E. Outpatient bacteremia: clinical findings in children under two years with initial temperatures of 39.5 degrees C or higher. J Pediatr. 1981 Aug;99(2):231–233. doi: 10.1016/s0022-3476(81)80458-1. [DOI] [PubMed] [Google Scholar]
  27. Winchester P. D., Todd J. K., Roe M. H. Bacteremia in hospitalized children. Am J Dis Child. 1977 Jul;131(7):753–758. doi: 10.1001/archpedi.1977.02120200035009. [DOI] [PubMed] [Google Scholar]
  28. Wolf S. M. Laboratory evaluation of the child with a febrile convulsion. Pediatrics. 1978 Dec;62(6):1074–1076. [PubMed] [Google Scholar]

Articles from British Medical Journal (Clinical research ed.) are provided here courtesy of BMJ Publishing Group

RESOURCES