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Manuel L. Fernández-Guerrero, MD; G. Renedo, MD
Fundación Jiménez Díaz Universidad Autónoma Madrid

JAMA. 1987;257(14):1898.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Del Rio and McGowan¹ recently reported the case of a 54-year-old woman with apparent hyposplenia in whom pneumococcal bacteremia developed and who had severe profuse diarrhea as the main symptom. Al-though this association has been recognized since Osler's time,² the pathogenesis of the enteric disorder associated with pneumococcal septicemia remains almost entirely unknown. We suggest that invasion of the intestinal wall and mesenteric lymph nodes by Streptococcus pneumoniae is the leading cause of diarrhea in such patients.

Report of a Case.—

A 5-year-old boy was admitted to the hospital because of fever and severe diarrhea. Two years before, a splenectomy had been performed elsewhere because of rupture of the spleen after a vehicle accident. A few hours before admission, fever and profuse diarrhea developed, with bowel movements occurring almost every 90 minutes. At the time of examination, his temperature was 39°C; blood pressure, 60/40 mm . . . [Full Text PDF of this Article]

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