Early pneumococcal sepsis after pulmonary aspiration and the adult respiratory distress syndrome

Bacterial pneumonia often complicates recovery several days after aspiration of gastric and oropharyngeal contents. Two children aspirated vomitus resulting in adult respiratory distress syndrome (ARDS) and suffered life-threatening pneumonia and septicemia caused by Streptococcus pneumoniae on the 2nd day after aspiration. We presume that inoculation of oropharyngeal bacteria into severely injured lung resulted in unusually rapid progression of infection. A high index of suspicion is necessary to detect this early complication because clinical signs of infection were obscured by ARDS.