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May 1970

Intravascular Coagulation Associated With Pneumococcal Bacteremia and Symmetrical Peripheral Gangrene

Author Affiliations


From the Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston. Dr. Stossel is now with the National Heart Institute, Bethesda, Md.

Arch Intern Med. 1970;125(5):876-878. doi:10.1001/archinte.1970.00310050114014

Peripheral gangrene was recently described as an unusual complication of bacteremia caused by staphylococci and streptococci.1 Results of blood coagulation studies performed on these patients were consistent with a consumption coagulopathy.1 This 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.2,3 Coagulation 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

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