Pneumococcal Sepsis as a Cause of Massive Splenic Infarction in Patient with Unknown Celiac Disease

Abstract

stended and diffusely tender without guarding or re-bound. Initial laboratory evaluation demonstrated: White Blood Cells (WBC) 37210 × 10 9 /liter; hemoglobin (Hb) 11.5 g/dL; platelets (PLT) 12 × 10 9 /liter; creatinine, 1.53 mg/dL; total bilirubin 1.3 mg/dL; direct bilirubin, 0.9 mg/dL; ALT 75 U/L; INR 1.39; fibrinogen 232 mg/ dl, activated partial thromboplastin (aPTT) 37 sec (ra-tio 1.39); C-reactive protein (CRP) 272 mg/L (normal < 5 mg/L), lactate 6.2 mmol/l. The chest X-ray and the abdomen X-ray were unremarkable.