2007 Volume 40 Issue 11 Pages 925-929
A 65-year-old man with no previous medical history was admitted to our hospital with sudden onset of pneumococcal bacteremia. Disseminated intravascular coagulation and multiple organ dysfunction developed rapidly. There was no apparent site of infection. An abdominal computed tomography scan showed a very small spleen and Howell-Jolly bodies were present in the blood smear. Therefore, we suspected that hyposplenia was involved with pneumococcal bacteremia. Despite intensive treatment with continuous hemodiafiltration, endotoxin adsorption and plasma exchange, he died on the 14 th hospital day. In general, the spleen plays an important role in immunological function as a filter for bacteria, and produces immunological antibodies specific for a polysaccharide capsule of Gram-positive bacteria such as Streptococcus pneumoniae. Splenic dysfunction has been recognized as a major risk factor for severe overwhelming infections of Streptococcus pneumoniae. There have been some reports describing overwhelming postsplenectomy sepsis (OPSI), but there are few previous reports describing pneumococcal bacteremia in patients with adult hyposplenia. We report here a rare case of pneumococcal bacteremia complicated by adult hyposplenia
