Khodasevich L S, Val'kov A Iu
Arkhangelsk Medical Academy.
Arkh Patol. 1998 May-Jun;60(3):37-40.
Clinical and pathological data on 10 children who died of pneumococcal infection were analyzed. The disease started as primary pneumococcal meningitis in 4 cases, secondary to otitis media meningitis in 1 and pneumococcal pneumonia in 5 cases. The latter complicated with secondary pneumococcal meningitis in 3 cases, pneumococcemia with hemolytico-uremic syndrome in 1 case. 9 patients died of infectious-toxic shock and 1 patient of massive bleeding from acute gastric and duodenal ulcers. The results suggest that a grave course of pneumococcal infection is due to development of the infectious-toxic shock. Emergence of metastatic suppurative focuses was indicative of sepsis. A fulminant form of pneumococcal sepsis--pneumococcemia--has no large or evident primary focus. Neuraminidase produced by pneumococci is responsible for development of hemolytico-uremic syndrome.