The major causative microorganism (Streptococcus pneumoniae) of lobar pneumonia. Pneumococci occur singly or as pairs or short chains of oval or lancet-shaped cocci, 0.05–1.25 micrometers each, flattened at proximal sides and pointed at distal ends. A capsule of polysaccharide envelops each cell or pair of cells. The organism is nonmotile and stains gram-positive unless degenerating.

Pneumococci have been isolated from the upper respiratory tract of healthy humans, monkeys, calves, horses, and dogs. Epizootics of pneumococcal infection have been described in monkeys, guinea pigs, and rats but are not the source of human infection. In humans, pneumococci may be found in the upper respiratory tract of nearly all individuals at one time or another. Following damage to the epithelium lining the respiratory tract, pneumococci may invade the lungs. They are the principal cause of lobar pneumonia in humans and may cause also pleural empyema, pericarditis, endocarditis, meningitis, arthritis, peritonitis, and infection of the middle ear. Approximately one of four cases of pneumococcal pneumonia is accompanied by invasion of the bloodstream by pneumococci, producing bacteremia. Although the high mortality of untreated pneumococcal infection has been reduced significantly by treatment with antibiotics, one of every six patients with bacteremic lobar pneumonia still succumbs despite optimal therapy. In addition, the number of isolates of pneumococci resistant to one or more antimicrobial drugs has been gradually but steadily increasing. For these reasons, prophylactic vaccination is recommended, especially for those segments of the population that are at high risk for fatal infection. The polyvalent vaccine contains the purified capsular polysaccharides of the 23 types that are responsible for 85% of bacteremic pneumococcal infection and has an aggregate efficacy of 65–70% in preventing infection with any of the types represented in it.