439:
As there are a range of different pneumococcal vaccines, the patient should be offered the most up to date ones (typically 23 valent polysaccharide vaccine and 13 valent conjugate vaccine), if they have not had them already as part of standard schedule. Repeat doses are recommended in patients
389:
is vital to preventing OPSI and may be the most important factor for preventing OPSI. More and more people are increasingly getting their healthcare information from the internet and the lack of reliable, readable and comprehensive information on the risks of
812:"Guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen. Working Party of the British Committee for Standards in Haematology Clinical Haematology Task Force"
451:
OPSI is almost always fatal without treatment, but modern treatment has decreased the mortality to approximately 40–70 percent. Individuals with OPSI are most commonly treated with
398:
poses a preventable risk factor for asplenic individuals. The majority (as many as 84%) of asplenic individuals are unaware of the risks of asplenia. Encouraging the wearing of
985:
861:"The prevention and treatment of infection in patients with an absent or dysfunctional spleen - British Committee for Standards in Haematology Guideline up-date"
433:
427:
158:(see Mechanism) and as such when removed by splenectomy it can lead to rapid unchallenged infection by encapsulated bacteria. The rapid progression from
1010:
443:
The CDC recommends against live vaccines and has specific advice for travellers, which includes malaria avoidance for asplenic individuals.
463:
The risk of OPSI is 0.23–0.42 percent per year, with a lifetime risk of 5 percent. Most infections occur in the first few years following
436:
in chapter 7 covers immunisation of people with underlying medical conditions that affect immunity which includes asplenic patients.
470:
The risk is greatest for children and elderly (70+ years old), but it can happen at any age. Greater risk is associated with
1035:
Schwartz PE, Sterioff S, Mucha P, Melton LJ, Offord KP (November 1982). "Postsplenectomy sepsis and mortality in adults".
1123:
1118:
960:
399:
251:
1128:
1006:
598:"Overwhelming infection in asplenic patients: current best practice preventive measures are not being followed"
337:
317:
143:
810:
Working Party of the
British Committee for Standards in Haematology Clinical Haematology Task Force (1996).
345:
325:
188:
159:
341:
333:
1070:
Cullingford GL, Watkins DN, Watts AD, Mallon DF (June 1991). "Severe late postsplenectomy infection".
475:
430:'s annual vaccine recommendations includes specifics for individuals without a functioning spleen.
362:
656:
Taniguchi, Leandro Utino; Correia, Mário Diego Teles; Zampieri, Fernando
Godinho (December 2014).
1095:
479:
312:
47:
739:
1087:
1052:
942:
890:
841:
792:
720:
685:
677:
627:
573:
555:
386:
374:
292:
circulation due to the loss of the splenic macrophages. Hence the bacteria are free to cause
270:
155:
148:
138:
42:
703:
Rosner, F. (April 1984). "Babesiosis in splenectomized adults. Review of 22 reported cases".
1079:
1044:
932:
924:
880:
872:
831:
823:
782:
712:
669:
617:
609:
563:
545:
321:
263:
986:"Immunisation of individuals with underlying medical conditions: the green book, chapter 7"
811:
311:
and phagocytosis by macrophages in the spleen. These include common human pathogens with
385:
Knowledge of the risks of asplenia correlates with a greatly reduced risk of OPSI, thus
937:
912:
885:
860:
836:
622:
597:
568:
533:
491:
403:
350:
220:
273:
component C3b. These types of antibodies and complement are immune substances called
1112:
787:
770:
716:
487:
86:
1099:
151:
and requires immediate treatment. Death has been reported to occur within 12 hours.
308:
300:
278:
231:
191:
such as fever or coughing, however later in infection symptoms may include shakes,
911:
Downing, Mark A.; Omar, Ahmed H.; Sabri, Elham; McCarthy, Anne E. (August 2011).
483:
471:
464:
415:
395:
353:(sugars) permit bacteria to evade phagocytosis by macrophages alone, since only
288:), IgG and C3b are still bound to bacteria, but they cannot be removed from the
255:
118:
82:
77:
66:
961:"2018 Adult Schedule by Health Conditions in Easy-to-read Format for Patients"
452:
266:
247:
176:
130:
1048:
876:
827:
681:
658:"Overwhelming post-splenectomy infection: narrative review of the literature"
559:
534:"Post-splenectomy sepsis: preventative strategies, challenges, and solutions"
262:. In particular, these macrophages are activated when bacteria are bound by
657:
293:
274:
192:
114:
94:
1083:
946:
796:
689:
631:
577:
402:
with information about the condition, the carrying of antibiotics, seeking
373:
Measures to prevent OPSI include vaccination, prophylactic antibiotics and
1091:
1056:
894:
845:
724:
673:
613:
391:
304:
285:
259:
216:
204:
200:
122:
70:
913:"Information on the Internet for asplenic patients: a systematic review"
550:
928:
411:
407:
358:
354:
329:
212:
208:
171:
771:"Prevention and management of infections in patients without a spleen"
243:
196:
163:
134:
126:
226:
The disease progresses rapidly from the above mentioned symptoms to
289:
509:
surgical recall, seventh edition, Lorne H. Blackbourne, page 469.
227:
414:
is endemic and seeking immediate medical attention following a
277:, molecules that bind to the surface of bacteria to facilitate
166:
is one of the things that makes OPSI particularly dangerous.
357:
are directly recognized by macrophages in phagocytosis. So
57:
24–48 hours following presentation with mild viral symptoms
361:
immunity in forms of IgG and complement proteins is the
129:. The infections are typically characterized by either
532:
Luu, Sarah; Spelman, Denis; Woolley, Ian J. (2019).
93:
76:
61:
53:
41:
26:
21:
154:The spleen is necessary for protection against
764:
762:
760:
591:
589:
587:
85:in the past 2–3 years, removal of spleen for
8:
738:Centers for Disease Control and Prevention.
234:and finally death in as little as 24 hours.
175:, which are tick-borne parasites that cause
1037:Journal of the American Medical Association
169:Another source of infection are species of
965:Centers for Disease Control and Prevention
434:The Green Book (immunisation guidance, UK)
428:Centers for Disease Control and Prevention
406:before travel, especially to places where
18:
936:
884:
835:
786:
621:
567:
549:
527:
525:
523:
521:
519:
517:
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99:Almost invariably fatal without treatment
1011:"Advising Travelers with Specific Needs"
365:'s response against bacterial capsules.
1009:; Andrew T. Kroger; David O. Freedman.
502:
107:overwhelming post-splenectomy infection
22:Overwhelming post-splenectomy infection
769:Davidson RN, Wall RA (December 2001).
284:When the spleen is no longer present (
906:
904:
859:Davies JM, et al. (2001-06-02).
299:Patients without a spleen often need
7:
651:
649:
647:
645:
643:
641:
490:when compared to splenectomy due to
467:, but the risk of OPSI is lifelong.
418:has been shown to reduce OPSI risk.
31:Overwhelming post-splenectomy sepsis
775:Clinical Microbiology and Infection
117:occurring in individuals following
14:
89:reasons, being under the age of 2
788:10.1046/j.1198-743x.2001.00355.x
187:OPSI may initially present with
65:Exposure to pathogens following
254:), which are immune cells that
1072:The British Journal of Surgery
113:) is a rare but rapidly fatal
1:
602:Journal of Clinical Pathology
538:Infection and Drug Resistance
717:10.1016/0002-9343(84)90298-5
705:American Journal of Medicine
917:Canadian Journal of Surgery
1145:
252:reticuloendothelial system
596:Waghorn DJ (March 2001).
1049:10.1001/jama.248.18.2279
877:10.1136/bmj.312.7028.430
828:10.1136/bmj.312.7028.430
476:hematological conditions
338:Streptococcus agalactiae
318:Streptococcus pneumoniae
144:Streptococcus pneumoniae
1084:10.1002/bjs.1800780626
346:Pseudomonas aeruginosa
326:Neisseria meningitidis
307:that normally require
269:(IgG1 or IgG3) or the
139:encapsulated organisms
1007:Camille Nelson Kotton
455:and supportive care.
349:). Capsules made of
342:Klebsiella pneumoniae
334:Hemophilus influenzae
156:encapsulated bacteria
123:permanent dysfunction
674:10.1089/sur.2013.051
614:10.1136/jcp.54.3.214
137:, and are caused by
1124:Medical emergencies
662:Surgical Infections
551:10.2147/IDR.S179902
416:bite from an animal
363:human immune system
189:mild viral symptoms
160:mild viral symptoms
1119:Bacterial diseases
929:10.1503/cjs.005510
740:"About Babesiosis"
480:sickle cell anemia
440:without a spleen.
313:bacterial capsules
258:(eat) and destroy
183:Signs and symptoms
48:Infectious disease
1015:Travelers' Health
988:. 10 January 2020
387:patient education
381:Patient education
375:patient education
149:medical emergency
103:
102:
16:Medical condition
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1129:Spleen (anatomy)
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322:Salmonella typhi
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1107:
1069:
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1064:
1043:(18): 2279–83.
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989:
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871:(7028): 430–4.
858:
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809:
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351:polysaccharides
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1027:
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923:(4): 232–236.
900:
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802:
781:(12): 657–60.
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668:(6): 686–693.
637:
583:
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448:
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404:medical advice
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246:contains many
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230:to refractory
221:abdominal pain
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1078:(6): 716–21.
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744:CDC Parasites
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544:: 2839–2851.
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301:immunizations
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250:(part of the
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87:hematological
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1018:. Retrieved
1014:
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968:. Retrieved
964:
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747:. Retrieved
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608:(3): 214–8.
605:
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459:Epidemiology
450:
442:
438:
432:
425:
384:
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316:
309:opsonization
298:
283:
279:phagocytosis
241:
232:septic shock
225:
186:
170:
168:
153:
142:
110:
106:
104:
78:Risk factors
34:
30:
484:thalassemia
472:splenectomy
465:splenectomy
453:antibiotics
422:Vaccination
396:splenectomy
256:phagocytose
248:macrophages
83:Splenectomy
67:splenectomy
54:Usual onset
27:Other names
1113:Categories
1020:25 October
992:2023-08-24
498:References
369:Prevention
275:opsonizers
271:complement
267:antibodies
177:babesiosis
147:. It is a
141:including
131:meningitis
682:1557-8674
560:1178-6973
447:Prognosis
400:bracelets
305:pathogens
294:infection
238:Mechanism
125:) of the
115:infection
95:Prognosis
43:Specialty
1100:23790214
947:21651833
797:11843905
690:25318011
632:11253134
578:31571940
478:such as
392:asplenia
355:proteins
303:against
286:asplenia
260:bacteria
217:headache
205:vomiting
201:diarrhea
71:asplenia
1092:2070242
1057:7131680
970:19 June
938:3191896
895:8601117
886:2350106
846:8601117
837:2350106
749:19 June
725:6424470
623:1731383
569:6748314
488:tumours
412:babesia
408:malaria
359:humoral
330:E. coli
213:myalgia
209:malaise
193:shivers
172:Babesia
119:removal
1098:
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492:trauma
244:spleen
197:chills
164:sepsis
135:sepsis
127:spleen
62:Causes
1096:S2CID
290:blood
1088:PMID
1053:PMID
1022:2018
972:2018
943:PMID
891:PMID
842:PMID
793:PMID
751:2018
721:PMID
686:PMID
678:ISSN
628:PMID
574:PMID
556:ISSN
486:and
474:for
426:The
410:and
394:and
242:The
228:coma
219:and
121:(or
111:OPSI
35:OPSS
1080:doi
1045:doi
1041:248
933:PMC
925:doi
881:PMC
873:doi
869:312
865:BMJ
832:PMC
824:doi
820:312
816:BMJ
783:doi
713:doi
670:doi
618:PMC
610:doi
564:PMC
546:doi
264:IgG
162:to
133:or
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