Case Studies

 Case 7.5 Fatal pneumococcal sepsis 8 years following splenectomy

A 35-year-old man felt non-specifically unwell for 24h before being found collapsed at home. Despite intensive attempts at resuscitation by ambulance staff he was pronounced dead on arrival in hospital. Post-mortem examination revealed acute bacterial pneumonia and meningitis due to Streptococcus pneumoniae. His previous medical history was unremarkable except for a ruptured spleen following a road traffic accident, necessitating emergency splenectomy, 8 years previously. It transpired that immunization with 'Pneumovax' (23 valent pneumococcal polysaccharide) had been overlooked at the time and the patient's compliance with subsequent antibiotic prophylaxis had been erratic.