Severe sepsis and septic shock may occur years after splenectomy. Other choices for antibiotic prophylaxis include penicillin or amoxicillin, and in penicillin-allergic patients, trimethoprim-sulfamethoxazole or clarithromycin may be substituted.
What infections are Asplenic patients at risk for?
Asplenia is a form of immunodeficiency, increasing the risk of sepsis from polysaccharide encapsulated bacteria, and can result in overwhelming post splenectomy infection (OPSI), often fatal within a few hours. In particular, patients are at risk from Streptococcus pneumoniae, Haemophilus influenzae, and meningococcus.
Do splenectomy patients need prophylactic antibiotics?
** Some authorities recommend lifelong oral antibiotic prophylaxis in all cases and particularly in the first two (2) years following splenectomy in adults and children aged over five (5) years. Adults with underlying immunosuppression, particularly those with malignancy, should be given antibiotic prophylaxis.
Are Asplenic patients immunocompromised?
7,8 Patients who have had a splenectomy or have functional asplenia are immunocompromised and are at increased risk for severe and overwhelming bacterial infections, particularly from encapsulated bacteria.
Which organism causes infection after splenectomy?
Overwhelming post-splenectomy infection is usually caused by the encapsulated bacteria Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis and more than half of those infected die.
What is post-splenectomy infection?
An overwhelming post-splenectomy infection (OPSI) is a rare but rapidly fatal infection occurring in individuals following removal (or permanent dysfunction) of the spleen.
What antibiotics are used for encapsulated bacteria?
The aim of medical therapy is to prevent invasive disease secondary to polysaccharide-encapsulated organisms, especially pneumococci. Penicillin and amoxicillin are currently the drugs of choice.
What type of infections are common in Asplenic individuals?
Asplenic patients have an increased risk for systemic, recurrent and severe invasive infections, most commonly sepsis or meningitis. These may be overwhelming and rapidly fatal with severe multiorgan failure and disseminated coagulopathy, a condition called “overwhelming postsplenectomy infections” (OPSI).
How do you treat Asplenic?
Antibiotic prophylaxis should be initiated immediately upon the diagnosis of asplenia because these patients are at significant risk of pneumococcal infections. For children younger than 2 years, oral penicillin V may be given twice a day. Amoxicillin has also been recommended as an appropriate prophylactic antibiotic.
What qualifies you as immunocompromised?
Being immunocompromised means having a weakened immune system, and many diseases and medications can cause this. If you’re immunocompromised, you may be at higher risk of getting severe COVID-19 disease. Immunocompromised people can get the COVID-19 vaccine, but it may not be as effective in some people.
What does Hyposplenism mean?
Hyposplenia is the reduced or absent function of the spleen, impairing the capacity to prevent bacterial infections.
Which is the commonest post-splenectomy infection?
In the late 1990s and early 2000s, pneumococcus was considered the predominant cause of infection post-splenectomy (57-87%). However, recent studies suggest that Neisseria meningitidis and Haemophilus influenzae (type b) are also common etiologic agents [28,29].
