Pneumonia

The main pathogens are pneumococci. They are widely distributed, and every second person carries them in the nasopharyngeal space without having symptoms.

Pneumococcal infections are particularly dangerous for splenectomized patients, the elderly, or other individuals with a weak immune system. The lethality of pneumococcal bacteremia is 30%, or even 50% in persons over 60. Vaccination will especially benefit those at high risk.

The most common pathogens of pneumonia are listed in Table 13.1.

Appendicitis

This is a common bacterial infection of the vermiform appendix, which is promoted by obstructing events. Occasionally, it is difficult to distinguish it from adnexal processes by differential diagnosis. It should therefore always be considered if there is pain on the right side of the lower abdomen. On the other hand, a gynecological examination should take place before appendectomy is performed in a young woman. Pain upon abrupt release of steady pressure (rebound tenderness) at McBurney point is characteristic for appendicitis, whereas pelvic inflammatory disease is almost always associated with cervicitis and purulent cervical secretion. Clear, threadable cervical secretion and normal inflammatory parameters indicate more a follicular cyst, rupture of an ovarian follicle, or something else. Examination by ultrasound will help to establish a diagnosis.

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