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| Asplenia increases the risk of septicaemia from encapsulated bacteria (OPSI - ]) which can kill within a few hours. In particular patients are at risk from ], but also ] & ]. | Asplenia increases the risk of septicaemia from encapsulated bacteria (OPSI - ]) which can kill within a few hours. In particular patients are at risk from ], but also ] & ]. | ||
| ''Antibiotic Cover'' | |||
| 1) Routine antibiotics as a prophylaxis is recommended (for the longer of 2 years after splenectomy or until the age of 16). | 1) Routine antibiotics as a prophylaxis is recommended (for the longer of 2 years after splenectomy or until the age of 16). | ||
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| 3) Prophylaxis is needed before certain surgical & dental proceedures | 3) Prophylaxis is needed before certain surgical & dental proceedures | ||
| ''Vaccination Cover'' | |||
| 1) ] every 6 years (a conjugated form is used for children under 2 years) | 1) ] every 6 years (a conjugated form is used for children under 2 years) | ||
Revision as of 00:48, 7 September 2004
Asplenia refers to the absence of normal spleen function and is associated with some risks. Asplenia may be congenital (congenital asplenia), or acquired through surgery splenectomy) or through processes that destroy the spleen, generally through its function to filter the blood and therefore referred to as auto-splenectomy (eg spherocytosis and sickle cell anaemia).
Asplenia increases the risk of septicaemia from encapsulated bacteria (OPSI - Overwhelming post splenectomy infection) which can kill within a few hours. In particular patients are at risk from pneumococcus, but also Haemophilus influenzae & meningococcus.
Antibiotic Cover
1) Routine antibiotics as a prophylaxis is recommended (for the longer of 2 years after splenectomy or until the age of 16).
2) In addition patients should be instructed to take antibiotic at the first onset of an upper or lower respiratory tract infection (for example, sore throat or cough) or onset of any fever.
3) Prophylaxis is needed before certain surgical & dental proceedures
Vaccination Cover
1) pneumococcus every 6 years (a conjugated form is used for children under 2 years)
2) Haemophilus influenzae once-only for previously non-immunised adults (its part of routine childhood vaccination in the UK)
3) meningococcus conjugate for C. Travel to sub-Saharan Africa needs Menigococcal A&C cover every 3 years
4) Annual flu vaccinations help prevent getting secondary bacterial infection.
The risk to asplenic patients has been expressed as equivalent for a child to die in home accident, and for adults dying in a road traffic accident (reference UK Splenectomy Trust Advice) - so sensible precautions are needed, but no panic.