Document Detail

Thrombotic microangiopathy associated with Streptococcus pneumoniae bacteremia: case report and review.
MedLine Citation:
PMID:  8110927     Owner:  NLM     Status:  MEDLINE    
Thrombotic microangiopathy, a disease within the clinical spectrum of thrombotic thrombocytopenic purpura and hemolytic-uremic syndrome, was recognized in a previously healthy 50-year-old woman who presented with pneumococcal bacteremia complicated by thrombocytopenia, microangiopathic hemolytic anemia, renal failure, and disorientation. After treatment with plasma exchange and antibiotics, the patient's clinical condition improved. Discontinuation of plasma exchange resulted in a relapse of thrombocytopenia and microangiopathic hemolytic anemia that responded to reinitiation of this intervention. The production of the enzyme neuraminidase by Streptococcus pneumoniae is thought to contribute to the pathogenesis of the thrombotic process. Although pneumococcal infection has been associated with hemolytic-uremic syndrome in children, review of the literature on adults revealed only one such case (in a patient who had undergone splenectomy in the remote past). This report therefore documents an unusual complication of pneumococcal bacteremia in an immunocompetent adult.
K A Myers; T J Marrie
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  17     ISSN:  1058-4838     ISO Abbreviation:  Clin. Infect. Dis.     Publication Date:  1993 Dec 
Date Detail:
Created Date:  1994-03-25     Completed Date:  1994-03-25     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1037-40     Citation Subset:  IM    
Department of Medicine, Victoria General Hospital, Dalhousie University, Halifax, Nova Scotia, Canada.
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MeSH Terms
Anemia, Hemolytic / etiology,  therapy
Bacteremia / complications*
Kidney Failure / etiology
Middle Aged
Plasma Exchange
Platelet Transfusion / contraindications
Pneumococcal Infections / complications*
Thrombocytopenia / etiology,  therapy
Thrombosis / etiology*,  therapy
Comment In:
Clin Infect Dis. 1995 Mar;20(3):720-1   [PMID:  7756507 ]

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