Streptococcus pneumoniae infections of the female genital tract and in the newborn child.

Streptococcus pneumoniae is not a part of the resident vaginal flora. However, in some women S. pneumoniae can be a transient part of the vaginal flora, and pelvic infection can occur, especially if a predisposing condition exists (e.g., use of an intrauterine contraceptive device, a recent birth, or gynecologic surgery). In the preantibiotic era, pneumococcal genital infection was more common than today, and the rate of lethality was high--26% for localized infection and 74% for peritonitis. During the last 25 years, all 24 patients reported worldwide survived their pneumococcal genital infections, including nine patients at our hospital; in contrast, five of 12 women died between 1938 and 1952. Pneumococci can rarely be isolated as the only pathogen in cases of bartholinitis. Neonatal S. pneumoniae disease with an early onset has an intrapartum pathogenesis. Of 23 reported pediatric patients (including one whom we treated), 48% died and 13% survived with neurologic sequelae. The prognosis for these children has not improved during the last 10 years.