We reviewed 71 consecutive patients with Streptococcus pneumoniae bact
eremia. The patients were analyzed by age, sex, ethnic background, and
clinical presentation. Laboratory data reviewed included a CBC count,
electrolyte levels, liver function studies, chest radiograph, HIV sta
tus, a sputum culture and Gram's stain, and sensitivities for the S pn
eumoniae isolated. Modalities of therapy, response to treatment, and u
ltimate outcome were examined. Many of the patients with pneumococcal
bacteremia did not have cough, fever, or chills. HIV positivity was a
risk factor for pneumococcal infection although it was not associated
with increased mortality, Mortality correlated with elderly status, le
ukopenia, and lack of fever, Many patients had symptoms suggestive of
atypical pneumonia including myalgia and mental status change. Hyponat
remia and hyperbilirubinemia were commonly noted.