THROMBOTIC MICROANGIOPATHY ASSOCIATED WITH STREPTOCOCCUS-PNEUMONIAE BACTEREMIA - CASE-REPORT AND REVIEW

Citation
Ka. Myers et Tj. Marrie, THROMBOTIC MICROANGIOPATHY ASSOCIATED WITH STREPTOCOCCUS-PNEUMONIAE BACTEREMIA - CASE-REPORT AND REVIEW, Clinical infectious diseases, 17(6), 1993, pp. 1037-1040
Citations number
19
Language
INGLESE
art.tipo
Note
Categorie Soggetti
Microbiology,Immunology
ISSN journal
1058-4838
Volume
17
Issue
6
Year of publication
1993
Pages
1037 - 1040
Database
ISI
SICI code
1058-4838(1993)17:6<1037:TMAWSB>2.0.ZU;2-Q
Abstract
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 wi th pneumococcal bacteremia complicated by thrombocytopenia, microangio pathic hemolytic anemia, renal failure, and disorientation. After trea tment with plasma exchange and antibiotics, the patient's clinical con dition improved. Discontinuation of plasma exchange resulted in a rela pse of thrombocytopenia and microangiopathic hemolytic anemia that res ponded to reinitiation of this intervention. The production of the enz yme 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 childr en, review of the literature on adults revealed only one such case (in a patient who had undergone splenectomy in the remote past). This rep ort therefore documents an unusual complication of pneumococcal bacter emia in an immunocompetent adult.