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Fever and asplenia: a dangerous association
  1. Halil Yildiz1,
  2. Jean Cyr Yombi2
  1. 1Medecine Interne, Cliniques Universitaires Saint-Luc, Brussels, Belgium
  2. 2Internal Medicine and Perioperative Medicine, Université catholique de Louvain, Brussels, Belgium
  1. Correspondence to Dr Halil Yildiz, halil.yildiz{at}, h_tur.bel{at}

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A 77-year-old splenectomised woman presented with temperatures reaching 38.5°C in the last 24 hours. The clinical presentation was non-specific and blood tests came back normal: a diagnosis of acute gastroenteritis was made. The patient’s clinical state then deteriorated rapidly; she developed septic shock, acute renal failure, disseminated intravascular coagulation and purpura fulminans with peripheral necrosis of toes and fingers (figure 1 A,B), as complications of a pneumococcaemia. Following appropriate antibiotic therapy and supportive …

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