Septicaemia and adrenal haemorrhage in congenital asplenia.

Dyke, M; Martin, Robin P.; Berry, P J

doi:10.1136/adc.66.5.636

Cited by 36 publications

(17 citation statements)

References 13 publications

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“…Mortality after acute presentation with sepsis is 56% [1,14,15]. Other series have reported up to an 80% mortality arising from sepsis [16,17].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Congenital Asplenia Revealed by Streptococcus oralis septicemia: Case Report

Fane¹,

Sodqi²,

Marih³

et al. 2017

J Antimicrob Agents

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Congenital asplenia is a rare life-threatening condition, often presenting with sepsis caused by encapsulated pathogens. It may arise as part of situs abnormalities or result from an unrelated specific defect of spleen development. Isolated congenital asplenia is a very rare condition. We report a case of asplenia revealed by severe sepsis and multi-organ failure in a previously healthy 25-year-old male how had never undergone any surgical procedures. Blood cultures grew Streptococcus oralis four days after admission. Computed tomography revealed pneumonia and asplenia. The patient was finally diagnosed as Streptococcal sepsis revealing isolated congenital asplenia. Cephalosporin and levofloxacin were administered and the patient died following cardiopulmonary arrests. No family history for this condition was reported. Clinicians should pay attention to the congenital asplenia in Streptococcal disease, particularly in the event of overwhelming sepsis. In affected individuals, the use of appropriate antibiotic prophylaxis and immunisations could save lives.

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“…Mortality after acute presentation with sepsis is 56% [1,14,15]. Other series have reported up to an 80% mortality arising from sepsis [16,17].…”

Section: Discussionmentioning

confidence: 99%

“…This is characterized by visceral heterotaxy with bilateral right-sidedness. The right-sided organs are duplicated and organs that are normally present on the left side are absent [7]. Congenital isolated asplenia is a separate entity due to a specific defect of spleen development [4].…”

Section: Discussionmentioning

confidence: 99%

Congenital Asplenia Revealed by Streptococcus oralis septicemia: Case Report

Fane¹,

Sodqi²,

Marih³

et al. 2017

J Antimicrob Agents

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“…Puede darse como un hallazgo aislado o como parte de un síndrome que frecuentemente va asociado a anormalidades cardiovasculares (síndrome de Ivemark) 3,8 . Sobre el 90% de los casos se asocia a cardiopatías congénitas complejas, dentro de las que se describen dos grandes grupos: asplenia asociada con isomerismo derecho que se presenta con pulmones trilobulares bilaterales y situs inversus abdominal, y polisplenia asociada con isomerismo izquierdo que se presenta con pulmones bilobulares bilaterales y heterotaxia abdominal 11 . En la Tabla 2 se enumeran las condiciones clínicas en las cuales se puede llegar a desarrollar una hiposplenia/ asplenia funcional.…”

Section: Causasunclassified

Asplenia e hiposplenia en pediatría: Prevención de sepsis bacteriana fulminante

Cofré

2014

Rev. chil. infectol.

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“…In this series, H. influenzae infection was not diagnosed even though it has been associated with adrenal hemorrhage. 8,10 Immunohistochemical assays permitted identification of intact bacteria (bacilli and cocci) and granular antigen staining. Detection of bacterial antigens using immunohistochemical assays has been observed in various bacterial infections including those caused by N. meningitidis, Clostridium spp., B. anthracis, Leptospira spp., and T. pallidum.…”

Section: -31mentioning

confidence: 99%

“…[2][3][4][5][6][7][8][9][10] Endotoxinmediated septic shock is the most frequent clinical condition seen in patients with infectious adrenal hemorrhage. These endotoxins, lypopolysaccharide in the case of Gram-negative bacteria and peptidoglycan for Gram-positive bacteria, bind through toll-like receptors to endothelial and inflammatory cells and induce a number of signaling pathways that lead to transcription of coagulation, fibrinolysis, and proinflammatory cytokine genes such as tissue factor, IL-1, IL-6 and TNFa.…”

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confidence: 99%

Adrenal gland hemorrhage in patients with fatal bacterial infections

Guarner

Paddock²,

Bartlett³

et al. 2008

Modern Pathology

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A wide spectrum of adrenal gland pathology is seen during bacterial infections. Hemorrhage is particularly associated with meningococcemia, while abscesses have been described with several neonatal infections. We studied adrenal gland histopathology of 65 patients with bacterial infections documented in a variety of tissues by using immunohistochemistry. The infections diagnosed included Neisseria meningitidies, group A streptococcus, Rickettsia rickettsii, Streptococcus pneumoniae, Staphylococcus aureus, Ehrlichia sp., Bacillus anthracis, Leptospira sp., Clostridium sp., Klebsiella sp., Legionella sp., Yersinia pestis, and Treponema pallidum. Bacteria were detected in the adrenal of 40 (61%) cases. Adrenal hemorrhage was present in 39 (60%) cases. Bacteria or bacterial antigens were observed in 31 (79%) of the cases with adrenal hemorrhage including 14 with N. meningitidis, four with R. rickettsii, four with S. pneumoniae, three with group A streptococcus, two with S. aureus, two with B. anthracis, one with T. pallidum, and one with Legionella sp. Bacterial antigens were observed in nine of 26 non-hemorrhagic adrenal glands that showed inflammatory foci (four cases), edema (two cases), congestion (two cases), or necrosis (one case). Hemorrhage is the most frequent adrenal gland pathology observed in fatal bacterial infections. Bacteria and bacterial antigens are frequently seen in adrenal glands with hemorrhage and may play a pathogenic role. Although N. meningitidis is the most frequent bacteria associated with adrenal gland pathology, a broad collection of bacteria can also cause adrenal lesions.

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Septicaemia and adrenal haemorrhage in congenital asplenia.

Cited by 36 publications

References 13 publications

Congenital Asplenia Revealed by Streptococcus oralis septicemia: Case Report

Congenital Asplenia Revealed by Streptococcus oralis septicemia: Case Report

Asplenia e hiposplenia en pediatría: Prevención de sepsis bacteriana fulminante

Adrenal gland hemorrhage in patients with fatal bacterial infections

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