title: Spectrum of infections in splenectomised thalassaemia patients.
abstract: Splenectomised thalassaemia patients are at risk of developing sepsis. As the infection may be life-threatening, treatment should be sought and given promptly. A retrospective study was performed amongst our thalassaemia major patients who were splenectomised. The vaccination status of each patient and the types of infections seen were reviewed to obtain a local perspective. In our cohort of 49 splenectomised patients, 25 patients required hospitalization for the treatment of infection. There were a total of 40 febrile episodes within this hospitalised group of which 27.5% were microbiologically documented infection with bacteraemia. The predominant causative organisms were gram negative rods and three patients succumbed to overwhelming septicaemic shock as a result of delayed presentation. Sixty percent of the febrile episodes were clinically documented infection and comprised mainly upper respiratory tract infections. Based on the spectrum of infections seen, there is a need to improve the patients' awareness level so that early treatment is sought. There is also a need to re-address the approach towards vaccination in this immunocompromised group of patients by administering a booster pneumococcal and influenza vaccination in an attempt to reduce morbidity.
authors: Department of Paediatrics, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur. zarinaal@ppukm.ukm.my
authors: A L
authors: AL
authors: Zarina
authors: K N
authors: KN
authors: Norazlin
authors: A
authors: A
authors: Hamidah
authors: D A
authors: DA
authors: Aziz
authors: S Z Syed
authors: SZ
authors: Zulkifli
authors: R
authors: R
authors: Jamal
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D006801:Humans; D018805:Sepsis / Q000453:epidemiology*; D013156:Splenectomy / Q000009:adverse effects*; D013789:Thalassemia / Q000150:complications / Q000601:surgery*