450:
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
400:
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
823:"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"
462:
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
409:
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
996:
872:"The prevention and treatment of infection in patients with an absent or dysfunctional spleen - British Committee for Standards in Haematology Guideline up-date"
444:
438:
169:(see Mechanism) and as such when removed by splenectomy it can lead to rapid unchallenged infection by encapsulated bacteria. The rapid progression from
1021:
454:
The CDC recommends against live vaccines and has specific advice for travellers, which includes malaria avoidance for asplenic individuals.
474:
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
447:
in chapter 7 covers immunisation of people with underlying medical conditions that affect immunity which includes asplenic patients.
481:
The risk is greatest for children and elderly (70+ years old), but it can happen at any age. Greater risk is associated with
1046:
Schwartz PE, Sterioff S, Mucha P, Melton LJ, Offord KP (November 1982). "Postsplenectomy sepsis and mortality in adults".
1134:
1129:
971:
410:
262:
1139:
1017:
609:"Overwhelming infection in asplenic patients: current best practice preventive measures are not being followed"
348:
328:
154:
821:
Working Party of the
British Committee for Standards in Haematology Clinical Haematology Task Force (1996).
356:
336:
199:
170:
352:
344:
17:
1081:
Cullingford GL, Watkins DN, Watts AD, Mallon DF (June 1991). "Severe late postsplenectomy infection".
486:
441:'s annual vaccine recommendations includes specifics for individuals without a functioning spleen.
373:
667:
Taniguchi, Leandro Utino; Correia, Mário Diego Teles; Zampieri, Fernando
Godinho (December 2014).
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490:
323:
58:
750:
1098:
1063:
953:
901:
852:
803:
731:
696:
688:
638:
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385:
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circulation due to the loss of the splenic macrophages. Hence the bacteria are free to cause
281:
166:
159:
149:
53:
714:
Rosner, F. (April 1984). "Babesiosis in splenectomized adults. Review of 22 reported cases".
1090:
1055:
943:
935:
891:
883:
842:
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793:
723:
680:
628:
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574:
556:
332:
274:
997:"Immunisation of individuals with underlying medical conditions: the green book, chapter 7"
822:
322:
and phagocytosis by macrophages in the spleen. These include common human pathogens with
396:
Knowledge of the risks of asplenia correlates with a greatly reduced risk of OPSI, thus
948:
923:
896:
871:
847:
633:
608:
579:
544:
502:
414:
361:
231:
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component C3b. These types of antibodies and complement are immune substances called
1123:
798:
781:
727:
498:
97:
1110:
162:
and requires immediate treatment. Death has been reported to occur within 12 hours.
319:
311:
289:
242:
202:
such as fever or coughing, however later in infection symptoms may include shakes,
922:
Downing, Mark A.; Omar, Ahmed H.; Sabri, Elham; McCarthy, Anne E. (August 2011).
494:
482:
475:
426:
406:
364:(sugars) permit bacteria to evade phagocytosis by macrophages alone, since only
299:), IgG and C3b are still bound to bacteria, but they cannot be removed from the
266:
129:
93:
88:
77:
972:"2018 Adult Schedule by Health Conditions in Easy-to-read Format for Patients"
463:
277:
258:
187:
141:
1059:
887:
838:
692:
669:"Overwhelming post-splenectomy infection: narrative review of the literature"
570:
545:"Post-splenectomy sepsis: preventative strategies, challenges, and solutions"
273:. In particular, these macrophages are activated when bacteria are bound by
668:
304:
285:
203:
125:
105:
1094:
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807:
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with information about the condition, the carrying of antibiotics, seeking
384:
Measures to prevent OPSI include vaccination, prophylactic antibiotics and
1102:
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905:
856:
735:
684:
624:
402:
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924:"Information on the Internet for asplenic patients: a systematic review"
561:
939:
422:
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369:
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340:
223:
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182:
782:"Prevention and management of infections in patients without a spleen"
254:
207:
174:
145:
137:
237:
The disease progresses rapidly from the above mentioned symptoms to
300:
520:
surgical recall, seventh edition, Lorne H. Blackbourne, page 469.
238:
425:
is endemic and seeking immediate medical attention following a
288:, molecules that bind to the surface of bacteria to facilitate
177:
is one of the things that makes OPSI particularly dangerous.
368:
are directly recognized by macrophages in phagocytosis. So
68:
24–48 hours following presentation with mild viral symptoms
372:
immunity in forms of IgG and complement proteins is the
140:. The infections are typically characterized by either
543:
Luu, Sarah; Spelman, Denis; Woolley, Ian J. (2019).
104:
87:
72:
64:
52:
37:
32:
165:The spleen is necessary for protection against
775:
773:
771:
602:
600:
598:
96:in the past 2–3 years, removal of spleen for
8:
749:Centers for Disease Control and Prevention.
245:and finally death in as little as 24 hours.
186:, which are tick-borne parasites that cause
1048:Journal of the American Medical Association
180:Another source of infection are species of
976:Centers for Disease Control and Prevention
445:The Green Book (immunisation guidance, UK)
439:Centers for Disease Control and Prevention
417:before travel, especially to places where
29:
947:
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797:
632:
578:
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110:Almost invariably fatal without treatment
1022:"Advising Travelers with Specific Needs"
376:'s response against bacterial capsules.
1020:; Andrew T. Kroger; David O. Freedman.
513:
118:overwhelming post-splenectomy infection
33:Overwhelming post-splenectomy infection
18:Overwhelming post splenectomy infection
780:Davidson RN, Wall RA (December 2001).
295:When the spleen is no longer present (
917:
915:
870:Davies JM, et al. (2001-06-02).
310:Patients without a spleen often need
7:
662:
660:
658:
656:
654:
652:
501:when compared to splenectomy due to
478:, but the risk of OPSI is lifelong.
429:has been shown to reduce OPSI risk.
42:Overwhelming post-splenectomy sepsis
786:Clinical Microbiology and Infection
128:occurring in individuals following
25:
100:reasons, being under the age of 2
799:10.1046/j.1198-743x.2001.00355.x
198:OPSI may initially present with
76:Exposure to pathogens following
265:), which are immune cells that
1083:The British Journal of Surgery
124:) is a rare but rapidly fatal
1:
613:Journal of Clinical Pathology
549:Infection and Drug Resistance
728:10.1016/0002-9343(84)90298-5
716:American Journal of Medicine
928:Canadian Journal of Surgery
1156:
263:reticuloendothelial system
607:Waghorn DJ (March 2001).
1060:10.1001/jama.248.18.2279
888:10.1136/bmj.312.7028.430
839:10.1136/bmj.312.7028.430
487:hematological conditions
349:Streptococcus agalactiae
329:Streptococcus pneumoniae
155:Streptococcus pneumoniae
1095:10.1002/bjs.1800780626
357:Pseudomonas aeruginosa
337:Neisseria meningitidis
318:that normally require
280:(IgG1 or IgG3) or the
150:encapsulated organisms
1018:Camille Nelson Kotton
466:and supportive care.
360:). Capsules made of
353:Klebsiella pneumoniae
345:Hemophilus influenzae
167:encapsulated bacteria
134:permanent dysfunction
685:10.1089/sur.2013.051
625:10.1136/jcp.54.3.214
148:, and are caused by
1135:Medical emergencies
673:Surgical Infections
562:10.2147/IDR.S179902
427:bite from an animal
374:human immune system
200:mild viral symptoms
171:mild viral symptoms
1130:Bacterial diseases
940:10.1503/cjs.005510
751:"About Babesiosis"
491:sickle cell anemia
451:without a spleen.
324:bacterial capsules
269:(eat) and destroy
194:Signs and symptoms
59:Infectious disease
1026:Travelers' Health
999:. 10 January 2020
398:patient education
392:Patient education
386:patient education
160:medical emergency
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27:Medical condition
16:(Redirected from
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1140:Spleen (anatomy)
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1054:(18): 2279–83.
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882:(7028): 430–4.
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833:(7028): 430–4.
820:
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934:(4): 232–236.
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792:(12): 657–60.
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741:
722:(4): 696–701.
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679:(6): 686–693.
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415:medical advice
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257:contains many
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241:to refractory
232:abdominal pain
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1089:(6): 716–21.
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755:CDC Parasites
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555:: 2839–2851.
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312:immunizations
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261:(part of the
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98:hematological
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1029:. Retrieved
1025:
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1001:. Retrieved
991:
979:. Retrieved
975:
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758:. Retrieved
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709:
676:
672:
619:(3): 214–8.
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552:
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480:
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470:Epidemiology
461:
453:
449:
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320:opsonization
309:
294:
290:phagocytosis
252:
243:septic shock
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181:
179:
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121:
117:
115:
89:Risk factors
45:
41:
495:thalassemia
483:splenectomy
476:splenectomy
464:antibiotics
433:Vaccination
407:splenectomy
267:phagocytose
259:macrophages
94:Splenectomy
78:splenectomy
65:Usual onset
38:Other names
1124:Categories
1031:25 October
1003:2023-08-24
509:References
380:Prevention
286:opsonizers
282:complement
278:antibodies
188:babesiosis
158:. It is a
152:including
142:meningitis
693:1557-8674
571:1178-6973
458:Prognosis
411:bracelets
316:pathogens
305:infection
249:Mechanism
136:) of the
126:infection
106:Prognosis
54:Specialty
1111:23790214
958:21651833
808:11843905
701:25318011
643:11253134
589:31571940
489:such as
403:asplenia
366:proteins
314:against
297:asplenia
271:bacteria
228:headache
216:vomiting
212:diarrhea
82:asplenia
1103:2070242
1068:7131680
981:19 June
949:3191896
906:8601117
897:2350106
857:8601117
848:2350106
760:19 June
736:6424470
634:1731383
580:6748314
499:tumours
423:babesia
419:malaria
370:humoral
341:E. coli
224:myalgia
220:malaise
204:shivers
183:Babesia
130:removal
1109:
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569:
503:trauma
255:spleen
208:chills
175:sepsis
146:sepsis
138:spleen
73:Causes
1107:S2CID
301:blood
1099:PMID
1064:PMID
1033:2018
983:2018
954:PMID
902:PMID
853:PMID
804:PMID
762:2018
732:PMID
697:PMID
689:ISSN
639:PMID
585:PMID
567:ISSN
497:and
485:for
437:The
421:and
405:and
253:The
239:coma
230:and
132:(or
122:OPSI
46:OPSS
1091:doi
1056:doi
1052:248
944:PMC
936:doi
892:PMC
884:doi
880:312
876:BMJ
843:PMC
835:doi
831:312
827:BMJ
794:doi
724:doi
681:doi
629:PMC
621:doi
575:PMC
557:doi
275:IgG
173:to
144:or
116:An
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