Intravascular Coagulation Associated With Pneumococcal Bacteremia and Symmetrical Peripheral Gangrene

Peripheral gangrene was recently described as an unusual complication of bacteremia caused by staphylococci and streptococci.¹Results of blood coagulation studies performed on these patients were consistent with a consumption coagulopathy.¹This communication concerns a patient in whom hypotension, purpura, and peripheral symmetric gangrene developed as consequences of bacteremia by another gram-positive organism, the pneumococcus. Tests of blood-clotting function have not been included in the few previous reports describing patients with pneumococcal bacteremia complicated by peripheral gangrene.²,³Coagulation analyses were performed on the patient described here, and a consumption coagulopathy was documented. Patient Summary A 32-year-old housewife had undergone a splenectomy in 1957 because of abdominal trauma. She was well until the morning of March 5, 1969, when she had a sudden, shaking chill followed by temperature of 104 F (40 C), faintness, vomiting, and diarrhea. During the following afternoon the patient complained of aching in the