Possible pathogenetic role of capsular antigens in fulminant pneumococcal disease with disseminated intravascular coagulation (DIC)

Rapidly progressive fatal pneumococcal sepsis in adults: a report of two cases

“…It has been reported that pneumococcal capsular polysaccharide antigens could initiate DIC either directly or as part of the antigen-antibody complex, by activation of complement. 15 In splenectomized individuals, the clearance activity of such substances is considered to be disturbed and contributes to the overwhelming presentation of Streptococcus pneumoniae. Reik et al reported that the detection of a peripheral buffy-coat blood smear was A B also associated with an excessively highly mortality rate.…”

Overwhelming Post-Splenectomy Infection: Narrative Review of the Literature

“…The prodrome, if present, is vague and short, with malaise, fever, shivering, myalgia, headache, vomiting, and abdominal pain progressing rapidly to coma, refractory septic shock, hypoglycemia, anuria, and disseminated intravascular coagulation (DIC) [45], the latter being an unusual finding in pneumococcal infection in patients with normal splenic function [48]. This frequent complication of OPSI might be related to the high burden of pneumococcus in the circulation (the pneumococci may be seen in blood smears) [46], which presents large amounts of pneumococcal capsular polysaccharide antigens to body fluids [49]. Activation of the complement pathway by polysaccharide-specific antibodies promotes deposition of complement fragments directly onto the pneumococcal capsule.…”

Sudden Death Caused by Fulminant Bacterial Infection: Background and Pathogenesis of Japanese Adult Cases

“…The cause of death in each case is circulatory collapse caused by fulminant infection (10,19 (3,4,(20)(21)(22)(23)(31)(32)(33)(34)(35)(36)(37). The onset of fulminant infection depends on the bacteria and the sensitivity of the host (38).…”