When asked for more details about her history, our patient mentioned her spleen was removed when she was a child because of a medical condition. The spleen is an important immune system organ that fights infections. People who have had a splenectomy are at risk of certain bacterial infections, including streptococcus pneumonia, which is why they should always get the pneumococcal vaccine. Being a smoker was another risk factor for our patient to develop pneumococcal infection.

Despite her strong risk factors, however, she had not received the pneumococcal vaccine.

About 18,000 people die in U.S. each year due to pneumococcal disease. Thousands of others get sick from this illness and require antibiotics, emergency room visits, and hospital admissions. Pneumococcal vaccine is now part of the routine childhood vaccination schedule and is recommended for all adults 65 and older, and anyone who is a smoker or who has conditions such as diabetes, liver cirrhosis, or chronic lung, kidney, or heart disease. Pneumococcal vaccine is also recommended for those with weakened immune systems, such as people with HIV, cancer, a damaged spleen, or who have had an organ transplant and must take antirejection medication.

The best way to prevent pneumococcal disease is to get vaccinated. Pneumococcal vaccines are widely available in doctors' offices, hospitals, and most pharmacies, and most major insurance plans cover them.

Before the patient left the hospital, she got a pneumonia vaccine. She said she certainly did not want to take any more chances.