Postsplenectomy pneumococcemia in adults.

We describe two adults with fulminant pneumococcemia and disseminated intravascular coagulation aftertraumatic splenectomy. One died in a few days, and the other survived with amputation of gangrenous toes and fingers. Although the relationship between the serious blood-borne bacterial infection with disseminated intravascular coagulation and lack of adequate splenic tissue has been well established, the mechanism is poorly understood and there are no specific therapeutic measures available. We review the literature in regard to the possible prophylactic measures and discuss the benefits of various measures.