title: Splenectomy in kala-azar.
abstract: At the beginning of the century, splenectomy was used in the treatment of kala-azar, but now is rarely needed, the major indication being for drug resistant kala-azar. Inadvertent splenectomy prior to the diagnosis of kala-azar continues to occur, probably because of a reluctance to perform splenic aspiration in the investigation of splenomegaly. Five Kenyan children underwent splenectomy for drug resistant kala-azar. All were immediately improved, but one died of overwhelming post splenectomy infection (OPSI) two months later and another of a malignant lymphoma seven months after surgery. The other three patients appear to be cured. Splenectomy was considered in a sixth child with kala-azar because of a Salmonella abscess in the spleen, but the abscess ruptured catastrophically before surgery could be arranged.
mesh_terms: D000328:Adult; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D008253:Macaca mulatta; D008288:Malaria / Q000628:therapy; D008297:Male; D013156:Splenectomy / Q000009:adverse effects; D013530:Surgical Wound Infection / Q000209:etiology