A Case of Invasive Pneumococcal Infection in a Patient with Splenic Hypoplasia

Abstract

We report a case of invasive pneumococcal infection, presumably associated with immune dysfunction, in a case of splenic hypoplasia. The patient, a 46–year–old man, was brought to our hospital by ambulance with a history of dull abdominal pain, diarrhea and vomiting. His abdomen was soft, with only mild tenderness in the epigastric area. His body temperature was 40.5℃. Blood tests showed evidence of only mild inflammation. Abdominal computed tomography showed mild fluid collection in the stomach and intestinal tract. The patient was diagnosed as having acute gastroenteritis and was started on fluid replacement therapy after admission. However, about 12 hours after arrival, he suddenly went into septic shock and disseminated intravascular coagulation (DIC), and died. An autopsy determined the cause of death to be multiple organ failure due to DIC. Subsequently, a positive result of a blood culture for Streptococcus pneumoniae was reported, and the patient was diagnosed as having had invasive pneumococcal infection. Review of a CT examination performed at admission revealed a reduced spleen volume of 38.6 mL, indicating splenic hypoplasia.