The clinical diagnosis of pneumococcal bacteremia is a challenge for physicians in ambulatory care settings. Many cases are "occult" and lack characteristic or pathognomonic signs.1,2 A previous report3 has suggested that oral lesions may be associated with Streptococcus pneumoniae bacteremia. This communication reports a case in which a similar gingival lesion was observed in an infant with pneumococcal bacteremia.
Report of a Case.—A previously healthy 7-month-old male infant had fever, irritability, and a swollen right cheek develop during the eight hours prior to admission. On the morning of admission, his mother noted swelling of the right maxillary gingiva. On admission, the rectal temperature was 40.3 °C. There was a cystic, pinkish, nontender, 2 × 1-cm mass on the posterior right maxillary gingiva. No gingival defect was seen. Both mandibular central incisors were erupted, but there were no other erupting teeth. The right cheek was erythematous, indurated, and