Hyposplenic, Coagulopathic, Cryptogenetic Pneumococcemia

An unusual case of sudden, fulminant pneumococcemia and disseminated intravascular coagulation occurred in a woman who had had incidental splenectomy 8 months previously, at the time of gastrectomy for duodenal ulcer. Similar cases in which there is constant relationship of splenectomy, pneumococcal sepsis, and Waterhouse-Friderichsen syndrome have been documented. Other similarities which are notable are a tendency for the disease to occur in women, lack of a nidus of infection, and proliferation of diplococci to numbers great enough to be seen easily on the peripheral blood smear.