Splenectomy and sudden death

Four cases of fatal fulminant Streptococcus pneumoniae septicemia in asplenic individuals have been presented, demonstrating the relative lack of specificity of the symptoms and rapidity of the clinical course. Vigorous specific therapy was without apparent effect in two of the cases. No apparent reticuloendothelial deficiency prior to splenectomy was detected in two cases, and theoretically rather than clinically present in the others. Individual was hyposplenic secondary to splenic atrophy. The rapidity of the course and unexpected death will often bring such cases under the jurisdiction of the coroner or medical examiner, and medicolegal investigators should be alert for this syndrome.