JOHN R. GUYTON, M.D.; ROSS E. ZUMWALT, M.D.
To the editor: The syndrome of asplenia, fulminant pneumococcemia, and disseminated intravascular coagulation has been described almost exclusively in association with atrophic or absent spleens (1). The following case of fatal pneumococcemia occurred in a patient with clinically unsuspected sarcoidosis, which had completely infiltrated the spleen.
A 36-year-old woman, previously well, presented with a 1-day history of fever, chills, and intermittent pleuritic chest pain without cough. Except for a temperature of 40 °C [104 °F], slight tachypnea (respiratory rate of 20/min), and some wheezing in the chest, physical examination was normal with no palpable lymphadenopathy or splenomegaly. The prothrombin time
GUYTON JR, ZUMWALT RE. Pneumococcemia with Sarcoid-Infiltrated Spleen. Ann Intern Med. ;82:847–848. doi: 10.7326/0003-4819-82-6-847
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Published: Ann Intern Med. 1975;82(6):847-848.
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