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To the Editor.—We read with interest the article by Drs. G. H. Mc-Cracken and J. D. Dickerman entitled "Septicemia and Disseminated Intravascular Coagulation" (Amer J Dis Child118:431-434, 1969). The association of overwhelming infection in postsplenectomy children is well known, and the complication of disseminated intravascular coagulation in these children is being recognized with increasing frequency, and indeed this complication was probably present and not appreciated in many of the early cases. We report an additional fatal case of disseminated intravascular coagulation in an 11½-year-old child in whom a splenectomy was performed for congenital hereditary spherocytosis at 5 years of age. She was not placed on prophylaxis and was essentially well until the present illness.
The patient had sudden onset of fever with temperature to 105 F, (40.6 C) followed by painful blue discoloration of hands, feet, and tip of nose. She was treated with ampicillin and became