PNEUMOCOCCAL DECISION TREE

DOES YOUR PATIENT HAVE ANY OF THE FOLLOWING RISK FACTORS?

  • Alcoholism
  • Cerebrospinal fluid (CSF) leak
  • Chronic heart*, liver, or lung** disease
    • ​Example: Heart failure!
  • Chronic renal failure
  • Cigarette smoking
  • Cochlear implant
  • Congenital or acquired asplenia
    • ​Example: splenectomy!
  • Congenital or acquired Immumnodeficiency***
  • Diabetes mellitus
  • Generalized malignancy
  • HIV infection
  • Hodgkin disease
  • latrogenic immunosuppression****
  • Leukemia
  • Lymphoma
  • Multiple myeloma
  • Nephrotic syndrome
  • Sickle cell disease and other hemoglobinopathies
  • Solid organ transplant​
Footnotes:
* Including congestive heart failure and cardiomyopathies, excluding hypertension

** Including chronic obstructive pulmonary disease, emphysema, and asthma

*** Includes B- (humoral) or T-lymphocyte deficiency, complement deficiencies (particularly C1, C2, C3, and C4 deficiencies), and phagocytic disorders (excluding chronic granulomatous disease)
​
**** Diseases requiring treatment with immunosuppressive drugs, including long-term systemic corticosteroids and radiation therapy