A patient with multiple myeloma and a normal spleen died with high-grade pneumococcal bacteremia diagnosed by routine examination of a Wright-stained peripheral blood smear. In earlier reports, this finding has been described only in patients with abnormal or absent spleens. We review the proposed mechanisms of high-grade pneumococcal bacteremia in these patients and the immunologic abnormalities in patients with multiple myeloma that may result in increased susceptibility to this infection.
(Arch Intern Med 138:1720-1721, 1978)
Posner MR, Berk SL, Rice PA. Pneumococcal Bacteremia Diagnosed by Peripheral Blood Smear in Multiple Myeloma. Arch Intern Med. 1978;138(11):1720-1721. doi:10.1001/archinte.1978.03630360094037