title: [Diagnosis by blood smear of a fulminant pneumococcemia complicating a myeloma].
abstract: BACKGROUND
  During a pneumococcal septicemia, the direct revelation of bacteria on a blood smear is rare and has been mainly described in splenectomised patients.
  
  
  METHODS
  A 62 year-old non-splenectomised man suffering from myeloma died, a few hours after his admission to emergency department, from a fulminant pneumococcemia, the diagnosis of which had been rapidly evoked on the examination of a blood smear showing numerous Gram positive diplococci.
  
  
  CONCLUSIONS
  This observation highlights the potential severity of pneumococcal infections in patients suffering from altered humoral immunity and the diagnostic interest, in this case, of a systematic routine blood smear permitting rapid initiation of appropriate treatment.
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000917:Antibody Formation; D001399:Azure Stains; D016470:Bacteremia / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D001431:Bacteriological Techniques / Q000379:methods*; D004351:Drug Resistance; D017809:Fatal Outcome; D005840:Gentian Violet; D006801:Humans; D016867:Immunocompromised Host; D018942:Macrolides; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000276:immunology / Q000628:therapy; D010619:Phenazines; D011008:Pneumococcal Infections / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D012720:Severity of Illness Index; D013194:Staining and Labeling / Q000379:methods*; D014916:Whole-Body Irradiation / Q000009:adverse effects
chemical_list: D000900:Anti-Bacterial Agents; D001399:Azure Stains; C035863:Gram's stain; D018942:Macrolides; D010619:Phenazines; D005840:Gentian Violet