Guckian J C
J Infect Dis. 1976 Aug;134(2):150-7. doi: 10.1093/infdis/134.2.150.
The cause of death in bacteremia due to Streptococcus pneumoniae remains unclear. The role of intravascular coagulation and splenectomy was investigated in rabbits with lethal pneumococcal bacteremia. The staphylococcal clumping titer in serum, a measure of fibrin degradation products, increased early and persisted until death. This titer correlated with the level of bacteremia. The partial thromboplastin time and platelet-rich plasma clotting time also increased as the disease worsened. However, the prothrombin time remained normal. 125I-labeled fibrinogen was cleared normally from the plasma of infected rabbits, whether intact or splenectomized. Similarly, the concentration of fibrogen in plasma remained normal, even though the level of fibrin degradation products increased, and no difference in these parameters was noted between intact and splenectomized rabbits. Fibrin deposition could not be detected in any of the organs studied. Neither the level of fibrin degradation products nor survival was affected by treatment with hydrocortisone, hexadimethrine, cytochrome c, carboxypeptidase B, epsilon-aminocaproic acid, or heparin. These data suggest that intravascular coagulation occurs in this experimental infection prior to the onset of shock but probably plays only a minor role in lethality.
肺炎链球菌所致菌血症的死亡原因尚不清楚。在患有致死性肺炎球菌菌血症的家兔中研究了血管内凝血和脾切除术的作用。血清中的葡萄球菌凝集效价（一种纤维蛋白降解产物的测量指标）早期升高并持续至死亡。该效价与菌血症水平相关。随着病情恶化，部分凝血活酶时间和富含血小板血浆凝血时间也增加。然而，凝血酶原时间保持正常。无论家兔是否完整或已行脾切除术，125I标记的纤维蛋白原均能从受感染家兔的血浆中正常清除。同样，尽管纤维蛋白降解产物水平升高，但血浆中纤维蛋白原的浓度仍保持正常，完整家兔和脾切除家兔在这些参数上未发现差异。在所研究的任何器官中均未检测到纤维蛋白沉积。用氢化可的松、六甲蜜胺、细胞色素c、羧肽酶B、ε-氨基己酸或肝素治疗对纤维蛋白降解产物水平和生存率均无影响。这些数据表明，在该实验性感染中，血管内凝血在休克发作之前就已发生，但可能在致死性方面仅起次要作用。
