Risk factors for mortality:
(1) male gender
(2) older age (decision level not specified)
(3) debilitated state
(4) immunodeficiency associated with HIV disease, immunosuppression, corticosteroid therapy, monoclonal gammopathy, or other cause
(5) malignancy
(6) asplenia
(7) chronic ethanol abuse
(8) sickle cell - beta thalassemia disease (may be related to splenic dysfunction)
(9) Down's syndrome
Clinical findings seen in patients who die:
(1) multisystem organ failure
(2) coagulopathy with hemorrhage
(3) secondary bacterial, viral or fungal infection
