70-year-old male, homeless, with general malaise and status febrilis. Death few days after hospital admission. Autopsy specimen.
- The structure of the spleen is maintained.
- Hyperaemia in the red pulp
- Numerous, partly centrally caseated epithelioid giant-cell granulomas
- No non-reactive necrosis
Pathogenesis: haematogenic spread in immune-suppressed individual (malnutrition, alcoholism). The lack of non-reactive necrosis shows that the patient was not completely anergic (in contrast to tuberculosis sepsis).