Guertler A T, Carter C T
Division of Emergency Medicine, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
J Emerg Med. 1996 Jan-Feb;14(1):33-8. doi: 10.1016/0736-4679(95)02048-9.
Fulminant pneumococcal sepsis is a rare but life-threatening illness usually occurring in patients with known splenic absence (postsplenectomy) or dysfunction (sickle cell anemia). Several medical illnesses, not typically recognized as being associated with abnormal spleen function, may be complicated by fulminant pneumococcal sepsis. We report a case of fatal pneumococcal sepsis in a patient diagnosed with mixed connective tissue disease who likely had systemic lupus erythematosus and unsuspected splenic fibrosis. Medical illnesses associated with functional asplenia, hematological findings suggesting splenic dysfunction, and confirmatory tests of hyposplenism are discussed.
暴发性肺炎球菌败血症是一种罕见但危及生命的疾病，通常发生在已知无脾（脾切除术后）或脾功能不全（镰状细胞贫血）的患者中。几种通常不被认为与脾功能异常相关的内科疾病，可能并发暴发性肺炎球菌败血症。我们报告一例诊断为混合性结缔组织病、可能患有系统性红斑狼疮且存在未被怀疑的脾纤维化的患者发生致命性肺炎球菌败血症的病例。文中讨论了与功能性无脾相关的内科疾病、提示脾功能不全的血液学检查结果以及脾功能减退的确证性检查。
