Case Background
Invasion of the blood stream by bacteria is a common cause of what is know as disseminated intravascular coagulation, or DIC; it is a condition in whit clotting of blood is widespread in the body.Toxins produced by the bacteria can initiate the clotting pathways of the serum clotting components.Tommy had an upper respiratory infection (URL) and an earache (otitis media, O.M. ) previous to his bout with DIC; bacteria from his URL or otitis media infection probably gained entrance to his bloodstream through his epithelial tissues, invading the submucosa until they encountered blood capillaries. Once in the blood (septicemia= bacteria in blood), the bacteria stimulated the clotting system.
Shock or a trauma situation can also stimulate DIC; one does not need to be infected with a microbe as Tommy was. The mechanism in noninfectious cases involves the release of tissue thromboplastin from damaged cells into the general circulation. For example, DIC can occur following childbirth (release of placental tissue thromboplastin ), during cancer degradation of tissue, or following crush injuries. Lack of blood flow to tissue during cardiovascular shock can lead to cell death ("infarcts" = cell death due to inadequate blood perfusion of the tissue) with release of cellular thromboplastin.
With DIC, therapy is iamed at the underlying cause, in Tommy's case the bacterial infection of the blood stream and meninges. Supportive measures are also undertaken: anticoagulants are sometime used to stop the DIC, and clotting factors and platelets used up during the DIC are replenished.