The brain is that of an infant; it shows very prominent congested superficial vessels with a thick
exudate covering much of the cortex.
This child presented at the age of three months with a one-week history of irritability
and crying. A lumbar puncture grew S. pneumoniae; there was no response to therapy and the
child died three days after admission. The child suffered Down's syndrome and at autopsy
congenital atrial septal defect was demonstrated. Histological examination of tissues showed
evidence of a terminal disseminated intravascular coagulation.