title: [Missing spleen: indication for pneumococcal vaccination].
abstract: Two female patients, aged 39 and 52 years, developed severe pneumococcal meningitis. Both patients had undergone splenectomy in the past (one after trauma and one for idiopathic thrombocytopenic purpura) and pneumococcal vaccination was only given immediately after the splenectomy. After antibiotic treatment and intensive care one patient remained disabled and the other patient died. There is a higher risk of developing severe sepsis after splenectomy, with Streptococcus pneumoniae being the causative micro-organism in more than 50% of cases. Vaccination after splenectomy in order to prevent a severe sepsis syndrome is very important. Indications for the 7 valent pneumococcal conjugate vaccine and the 23 valent polysaccharide vaccine are given.
authors.affiliation: Afd. Neurologie, Universitair Medisch Centrum Utrecht, Postbus 85.500, 3508 GA Utrecht.
authors.forename: G W
authors.initials: GW
authors.lastname: van Dijk
authors.forename: H J
authors.initials: HJ
authors.lastname: van Leeuwen
authors.forename: J
authors.initials: J
authors.lastname: van Gijn
authors.forename: I M
authors.initials: IM
authors.lastname: Hoepelman
mesh_terms: D000328:Adult; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008586:Meningitis, Pneumococcal / Q000209:etiology / Q000517:prevention & control*; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000209:etiology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D012307:Risk Factors; D013156:Splenectomy / Q000009:adverse effects*
chemical_list: C414006:23-valent pneumococcal capsular polysaccharide vaccine; D022242:Pneumococcal Vaccines