[First manifestation of multiple myeloma as lethal streptococcal sepsis].

Background: The multiple myeloma has the highest incidence among tumors of the bone and the bone marrow. Due to its rather mild and uncharacteristic clinical onset, first diagnosis of multiple myeloma is often delayed.

Case Report: The case of a 60-year-old female patient is reported who had been admitted to the authors' hospital in a state of severe septicemia.

Reduced release of pneumolysin by Streptococcus pneumoniae in vitro and in vivo after treatment with nonbacteriolytic antibiotics in comparison to ceftriaxone.

Pneumolysin, a virulence factor of Streptococcus pneumoniae with cytotoxic and proinflammatory activities, occurs at concentrations from 0.85 to 180 ng/ml in cerebrospinal fluid (CSF) of meningitis patients. In pneumococcal cultures and in a rabbit meningitis model, the concentrations of pneumolysin in supernatant and CSF were lower after addition of nonbacteriolytic bactericidal antibiotics (rifampin and clindamycin) than after incubation with ceftriaxone.