- Upper respiratory infections (e.g. otitis media)
- Bacteremia if severe
- S/p splenectomy or fxnl asplenia
- Eldery and very young
- Any chronic medical condition→ copd, liver or renal dz, chf, cancer, diabetes, HIV, or otherwise immunocompromised
- Cochlear implants
- Decreased risk if vaccinated
- Increased risk pneumococcal pneumonia post viral infection
- Cough, sputum, sob, chest pain
- HA, confusion, neck stiffness
- Other focality based on seeding