Fulminant-type pneumococcal infection in a heavy drinker: a case report

Abstract

We report a case of fulminant-type pneumococcal infection in a 48-year-old man who was a heavy drinker, present-ing disseminated intravascular coagulation (DIC) and multiple organ failure (MOF). His limbs and trunk showed rapidly progressive purpura. He died only 13 hours after admission despite of intensive therapy. Autopsy revealed presence of petechiae and small thrombi in many organs, bilateral adorenocortical hemorrhage, pulmonary conges-tion, and a small spleen, but no focal signs of the original infection. The etiologic agent was Streptococcus pneumo-nia identified by blood culture. Fulminant-type pneumococcal infection can cause sudden onset of sepsis, DIC, and MOF, leading to death within a few days. There have been few reports on the general pathologic examination of fulminant pneumococcal infection in Japan. Based on the accumulation of case reports of fulminant pneumococcal infection including post-mortem examinations, it is important to elucidate the molecular mechanisms of fulminant infection and to clarify whether alcohol abuse is a risk factor or not. (JJAAM. 2014; 25: