Dressed Down by the Captain of the Men of Death (Again)

The bacterium Streptococcus pneumoniae or the pneumococcus was labeled the "Captain of the Men of Death" by Sir William Osler because of its extreme prowess at killing. Today we are fortunate that the availability of pneumococcal vaccines has diminished the burden of invasive pneumococcal disease but it still causes approximately 3500 deaths per year. Those with the bacteria in their bloodstream succumb to the infection in 15% of cases--a figure that is thought not to have improved for decades despite myriad improvements in critical care. 

In my career I've taken care of several patients with severe pneumococcal infections and each time I am astounded by its deathly abilities. Last night, I unfortunately saw pneumococcus in action once again in a cirrhotic patient (who I don't believe was vaccinated).

There's a concept in treating patients with septic shock known as decompensation. Human physiology can hold out for so long and then, the deluge. Once decompensation occurs, it becomes a Herculean task to counteract the derangements induced by the infection, which soon become irreversible, and maintaining a blood pressure can become near impossible.

Pneumococcal vaccines, a life-saving technology developed by Dr. Robert Austrian, have the ability to make these types of occurrences a remnant of the past but if only if we avail ourselves of their benefits. For in those unlucky individuals in whom severe pneumococcal sepsis ensues, to rescue them requires beating back the devil.