Latos D L, Stone W J
Johns Hopkins Med J. 1978 Nov;143(5):165-8.
A chronic hemodialysis patient, previously splenectomized because of trauma in conjunction with gastrectomy, developed bacteremia with type 18 Streptococcus pneumoniae and died within 13 hours of onset of symptoms. Characteristics of this illness were severe hypoglycemia, pneumococci visible on peripheral blood smear, disseminated intravascular coagulation, neutropenia, and in vitro hemolysis. Splenectomy should be considered with caution in uremic patients and in renal transplant recipients because of the increased risk of fulminant bacteremia. Polyvalent pneumococcal vaccine may be helpful in preventing this syndrome in such asplenic patients.
一名慢性血液透析患者，此前因外伤合并胃切除术而接受了脾切除术，感染了18型肺炎链球菌败血症，并在症状出现后13小时内死亡。该疾病的特征为严重低血糖、外周血涂片可见肺炎球菌、弥散性血管内凝血、中性粒细胞减少和体外溶血。由于暴发性菌血症风险增加，对于尿毒症患者和肾移植受者，脾切除术应谨慎考虑。多价肺炎球菌疫苗可能有助于预防此类无脾患者的这种综合征。
