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Hyposplenic, coagulopathic, cryptogenetic pneumococcemia.

R E Wenk, D Dutta

    American Journal of Clinical Pathology
    |September 1, 1975
    PubMed
    Summary
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    Splenectomy increases the risk of sudden pneumococcal sepsis and Waterhouse-Friderichsen syndrome, particularly in women. Prompt recognition and treatment are crucial following spleen removal.

    Area of Science:

    • Medicine
    • Infectious Diseases
    • Hematology

    Background:

    • Splenectomy, the surgical removal of the spleen, can impair immune function.
    • Patients without a spleen are at increased risk for overwhelming post-splenectomy infection (OPSI).
    • Certain bacteria, like Streptococcus pneumoniae, pose a significant threat to asplenic individuals.

    Observation:

    • A case of sudden, fulminant pneumococcemia and disseminated intravascular coagulation (DIC) is presented.
    • The patient had undergone a splenectomy 8 months prior for a duodenal ulcer.
    • The presentation mimicked Waterhouse-Friderichsen syndrome, a severe form of meningococcal sepsis.

    Findings:

    • The patient experienced rapid, severe pneumococcal sepsis without an obvious source of infection.

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  • A characteristic finding was the high number of diplococci observed on peripheral blood smears.
  • This case highlights the potential for overwhelming pneumococcal disease following splenectomy.

    • Implications:

    • Splenectomy necessitates lifelong vigilance for severe infections, particularly pneumococcal disease.
    • Early recognition of pneumococcal sepsis in asplenic patients is critical for timely intervention.
    • This case underscores the importance of vaccination and prophylactic antibiotics in asplenic individuals.