Streptococcus pneumoniae is now, as in the past, the most common bacterial cause of pneumonia and acute otitis media in all age groups. In children more than 1 month old, the pneumococcus is the most frequent cause of bacteremia. Recent reports1-5 have renewed interest in pneumococcal sepsis in young children and have raised provocative questions about diagnosis and management. How frequent is pneumococcal bacteremia in the young child? Can children with blood cultures positive for pneumococcus be differentiated from those with noninvasive pneumococcal or other infections? How serious an event is pneumococcal bacteremia in the young child? How aggressive should the physician be in making the diagnosis and treating pneumococcal bacteremia?
The incidence of pneumococcal bacteremia in various reports depends on the selection of patients for culture of the blood, the methods used, the number of cultures, and the time in the course of the illness when the blood