Mechanism of Anaemia in Experimental Bacterial Endocarditis

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Abstract
Rabbits with Streptococcus viridans aortic valve endocarditis develop anaemia and reticulocytosis which increase with the duration of infection. Mean red cell counts decreased from 6.05 ± 0.29 × 106 per μl before infection to 4.10 ± 0.18 × 106 per μl after 11 to 20 days of endocarditis and reticulocytes increased from 1.16 ± 0.14 × 105 per μl to 4.91 ± 0.83 × 105 per μl after more than 20 days of endocarditis. The anaemia could not be explained by intravascular haemolysis. Anti‐erythrocyte antibodies were not detected. Splenomegaly was a consistent finding and also increased with the duration of infection. Red cell half life (T½) was shortened to 4.7 ± 0.3 days in rabbits with endocarditis compared with normal T½ of 11.1 ± 0.5 days. The T½ of red cells from infected animals was prolonged when measured in noninfected rabbits and splenectomized animals had a mean red cell T½ of 9.25 days after three weeks of infection. These studies suggest that splenic enlargement associated with infection results in red cell sequestration, a mechanism not well recognized as contributing to the anaemia of endocarditis.

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