Transmission via the secretions of carriers can result from direct interpersonal contact or contact with a contaminated surface. Bacteria on contaminated surfaces can be easily cultured. In conditions with sufficient nutrients, pneumococci can survive for 24 hours and avoid desiccation for multiple days. Reduced transmission has been observed amongst children with Pneumococcal conjugate vaccine (PCV) immunization as acquisition of a new strain of S. pneumoniae is inhibited by pre-existing colonization. Immunoglobulin G (IgG) immunization with high antibody concentration can also inhibit acquisition. These antibodies require the agglutinating function of the Fc fragment. For successful acquisition in a new host, pneumococcus must successfully adhere to the mucous membrane of the new host’s nasopharynx. Pneumococcus is able to evade detection by the mucous membrane when there is a higher proportion of negatively charged capsules. This clearance is mediated by Immunoglobulin A1 (IgA1) which is abundant on the URT mucosal surfaces. Colonization
Transparent and opaque colony morphology has been observed for pneumococci. Airway colonization is observed in transparent phenotypes of serotypes, while survival in bloodstreams is observed for opaque phenotypes. Colonizable strains exhibit resistance against neutrophilic immune response. Successful colonization requires S. pnuemoniae to evade detection by the nasal mucus and attach to epithelial surface receptors. Asymptomatic colonization occurs when S. pneumoniae bind to N-acetyl-glucosamine on epithelium without inflammation. However, co-infection with a pre-existing inflammatory URT infection results in an over-expression of the epithelial receptors utilized by S. pneumoniae, thus increasing the likelihood of colonization.
Clinical sign and symptoms can be differ according to system it involves. Diagnosis
features of systemic inflammatory response syndrome tachycardia >90beats/min 
tachypnea >24/min
temperature >38 or <36

Treatment
Antibiotics are effective. Prophylactic treatment consists in prevention of suppuration. Cultural references
Ignaz Semmelweis, the original proponent of hand-washing in the practice of medicine, was widely scorned for his belief and was committed to an insane asylum where he died at age 47 of pyaemia, after being beaten by the guards, only 14 days after he was committed. The nihilistic character Bazarov in Ivan Turgenevs Fathers and Sons dies of pyaemia. Miller Huggins, manager of the New York Yankees, died of pyaemia while managing the team during the 1929 season. Blind Boy Fuller died at his home in Durham, North Carolina on February 13, 1941, at 5 p.m. of pyemia due to an infected bladder, gastrointestinal tract and perineum, plus kidney failure. Casper, a wounded soldier in "Nostalgia," by Dennis McFarland, is dying of pyemia after his lower arm is amputated. References


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