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An overwhelming post-splenectomy infection (OPSI) is a rare but rapidly fatal infection occurring in individuals following removal (or permanent dysfunction) of the spleen. The infections are typically characterized by either meningitis or sepsis , and are caused by encapsulated organisms including Streptococcus pneumoniae . [ 3 ]
Therefore, patients are administered the pneumococcal conjugate vaccine (Prevnar), Hib vaccine, and the meningococcal vaccine post-operatively (see asplenia). These bacteria often cause a sore throat under normal circumstances but after splenectomy, when infecting bacteria cannot be adequately opsonized, the infection becomes more severe.
Acquired asplenia occurs for several reasons: . Following splenectomy due to splenic rupture from trauma or because of tumor; After splenectomy with the goal of interfering with splenic function, as a treatment for diseases (e.g. idiopathic thrombocytopenic purpura, thalassemia, spherocytosis), in which the spleen's usual activity exacerbates the disease
This abscess develops after surgical operations like splenectomy. Presents with cough, increased respiratory rate with shallow respiration, diminished or absent breath sounds, hiccups, dullness in percussion, tenderness over the 8th–11th ribs, fever, chills, anorexia and shoulder tip pain on the affected side.
Overwhelming post-splenectomy infection is associated with encapsulated organisms such as Capnocytophaga canimorsus. [11] Of the cases presented in literature, 33% occurred in asplenic individuals, who have decreased IgM and IgG production. They also have delayed macrophage assembly and produce less tuftsin. [10]
Lack of a spleen, called asplenia, can occur by autosplenectomy or the surgical counterpart, splenectomy. Asplenia can increase susceptibility to infection. [3] Autosplenectomy can occur in cases of sickle-cell disease where the misshapen cells block blood flow to the spleen, causing scarring and eventual atrophy of the organ. [2]
Post-acute infection syndromes (PAISs) or post-infectious syndromes are medical conditions characterized by symptoms attributed to a prior infection. While it is commonly assumed that people either recover or die from infections, long-term symptoms—or sequelae —are a possible outcome as well. [ 1 ]
[25] [13] Post-splenectomy patients will require lifelong antibiotic prophyllaxis to prevent infections. Study of eltrombopag , a thrombopoietic agent used to increase platelets in immune thrombocytopenic purpura (ITP), in WAS concluded that although it increased platelet numbers it failed to increase platelet activation in most patients. [ 26 ]