Rein PU, et al. - In patients who rapidly developed septic shock with multiorgan failure, the course of severe pneumococcal sepsis was analyzed in a combined retrospective and prospective cohort study. All cases with pneumococcal sepsis requiring mechanical ventilation, admitted to Medical Intensive Care Unit at Oslo University Hospital Ullevaal during an 8-year period (01 January 2016 to 31 December 2013), were studied. Findings revealed a rapid development of septic shock in all cases with pneumococcal sepsis and respiratory failure, even in young healthy individuals. Variability in initial clinical features was obvious; none were treated with antibiotics before admission. High mortality (40%) and high morbidity with limb amputations and neurological complications, were observed.