title: [Splenic rupture as a complication of ventilation in the prone position and pneumococcal sepsis as a late complication].
abstract: We are reporting the case of a female patient who had to undergo splenectomy after she suffered splenic rupture as a result from "kinetic therapy" during the treatment for pulmonary failure secondary to sepsis. Four years later the patient was again admitted with a clinical picture consistent with sepsis. Two blood cultures were positive for pneumococci confirming the diagnosis of pneumococcal sepsis. This paper discusses the potential risks of kinetic therapy in patients with ARDS. After splenectomy there is increased risk of infection with certain bacteria, funghi, viruses and protozoa. The most common bacterial pathogen is pneumococcus. A polyvalent vaccine is available for prophylaxis. Although penicillin G is still commonly used as an antibiotic therapy for pneumococcal infection, increased resistance of pathogens to penicillin must be anticipated. Alternative antibiotic regimens are demonstrated.
authors.affiliation: Abteilung für Anästhesie und Intensivmedizin, Krankenhaus der Barmherzigen Brüder in München.
authors.forename: F
authors.initials: F
authors.lastname: Brettner
authors.forename: E
authors.initials: E
authors.lastname: Tsekos
authors.forename: A
authors.initials: A
authors.lastname: Schmidt
authors.forename: G
authors.initials: G
authors.lastname: Miravalles
authors.forename: A
authors.initials: A
authors.lastname: Manz
authors.forename: H
authors.initials: H
authors.lastname: Hillmeier
authors.forename: B
authors.initials: B
authors.lastname: Bressler
authors.forename: M
authors.initials: M
authors.lastname: Mayer
authors.forename: G
authors.initials: G
authors.lastname: Boeden
mesh_terms: D005260:Female; D006801:Humans; D008875:Middle Aged; D026741:Physical Therapy Modalities / Q000009:adverse effects*; D011018:Pneumonia, Pneumococcal / Q000150:complications*; D016684:Prone Position; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000628:therapy*; D012138:Respiratory Therapy; D012421:Rupture; D018805:Sepsis / Q000150:complications*; D013154:Spleen / Q000293:injuries*; D013156:Splenectomy