Pneumococcal bacteremia in pediatric patients.

Patients treated for pneumococcal bacteremia were prospectively evaluated over a 21-month period. Of 2,610 blood cultures obtained, 79 (3%) were positive for Streptococcus pneumoniae. Of these, 37 patients (47%) initially had a focus of infection, and 73 (92%) were reevaluated after the results of the blood culture were known. Two-thirds of these were evaluated within 24 hours of the blood culture being drawn; the remainder were seen between 24 and 72 hours after the initial visit. Twenty-three patients were febrile (greater than 37.4 C) on reevaluation. Six demonstrated persistence of the original disease, nine showed no focus of infection, seven developed a focus of infection, and one developed a second focus of infection. No patients with temperatures less than 37.4 C developed significant disease. A regimen for management of patients with pneumococcemia is given.