Premium
Fulminant postsplenectomy sepsis
Author(s) -
Perkins Andrew C.,
Joshua Douglas E.,
Gibson John,
Kronenberg Harry
Publication year - 1988
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1988.tb104485.x
Subject(s) - medicine , splenectomy , fulminant , sepsis , pneumococcal vaccine , vaccination , asplenia , intensive care medicine , streptococcus pneumoniae , pneumococcal vaccination , thrombocytopenic purpura , superinfection , complication , penicillin , pneumococcal infections , pediatrics , immunology , antibiotics , surgery , spleen , immune system , virus , microbiology and biotechnology , biology
The vital role of a normally‐functioning spleen in a host's defence against circulating microorganisms has been realized for many years. The fulminant clinical course that characterizes infection with encapsulated microorganisms in asplenic patients is highlighted in these cases of severe pneumococcal sepsis in two patients, 10 and 13 years after splenectomies for idiopathic thrombocytopenic purpura. Approaches to the acute management of septic episodes and preventive measures are discussed. Pneumococcal vaccination reduces the incidence of infection effectively in asplenic patients and has a low complication rate. Penicillin by mouth is also efficacious in this situation, but patient compliance is low. Our current practice is to offer pneumococcal vaccination to all patients who have undergone splenectomy in the past and to administer the vaccine two weeks before elective splenectomies. Asplenic patients should be educated about the potential dangers of a septic episode and should be urged to seek an early medical consultation when this occurs.