Secondary pneumonia infection. 2-year-old boy who is wearing a respirator to aid his breathing after secondary infection by a drug-resistant pneumonia bacterium. The infection developed following open heart surgery for congenital heart disease (a birth defect in his heart). Drug-resistant infections and secondary infections are more common in hospitals and in patients who have undergone surgery. In this case, the infection is by drug-resistant Streptococcus pneumoniae (DRSP). This can cause pneumonia, a lung infection that causes difficulties with breathing. Photographed in Thailand.