(1) These complications include pleural infection or empyema, meningitis, purulent pericarditis, or endocarditis.

(2) In such outbreaks, pneumococcal infections have included sepsis, meningitis, purulent conjunctivitis, recurrent otitis media and sinusitis.

(3) The bacterium - which, when symptomatic, causes purulent discharge, dysuria, and urethritis - can also cause ascending infections leading to pelvic inflammatory disease and infertility.

(4) There was swelling, tenderness, erythema, and slight purulent discharge from the lesion.

(5) In patients with an obvious focus of infections (eg, purulent nasal discharge, abdominal tenderness, profuse green diarrhea), a focused diagnostic workup is required.