Antigenemia in fulminant pneumococcemia.

Two asplenic patients with fulminant pneumococcemia developed purpura and coagulopathy. Levels of C3 and C4 in the serum were low. Both patients had high levels of circulating capsular polysaccharide, and one patient had visible diplococci on a smear of the peripheral blood. Pneumococcal group C polysaccharide (C-substance) was detected in the serum of one of the patients. Possible pathogenetic relation of circulating pneumococcal antigens to the development of coagulopathy in pneumococcemia is discussed.