[Update on prevention of infections in patients without spleen or with diminished splenic function].
Patients without spleen or with diminished splenic function are at high risk (10-50 times higher than in normal population) of developing life-threatening infections (OPSI). Mortality from OPSI is estimated at 50 to 80% of cases. More frequent causative agents are encapsulated bacteria: Streptococcus Pneumoniae, Haemophilus influenzae type b and Neisseria Meningitidis. The risk of OPSI can be reduced by immunizing patients against these pathogens and by prescribing antibiotic prophylaxis. Continuous antibiotic prophylactic for 2-5 years after splenectomy (longer periods might expose the patients to the risk of antibiotic resistance) with penicillin or amoxicillin/clavulanate acid is mandatory. Asplenic individuals should take empirical antibiotic therapy - so called "self-treatment" - and immediate medical consultation in presence of febrile illness. All patients and their parents should be carefully educated about the risk of infections in order to obtain a good long-term compliance with these recommendations.
Cattedra di Pediatria Università Magna Graecia di Catanzaro Catanzaro, Italia - roberto.miniero@unicz.it.
R
R
Miniero
M
M
Barretta
T R
TR
Dolceamore
G
G
De Luca
F
F
Altomare
P
P
Chiarello
I
I
Gentile
P
P
Saracco
F
F
Zurlo
G
G
Bona
D019072:Antibiotic Prophylaxis; D001424:Bacterial Infections / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control*; D005190:Family; D006801:Humans; D010349:Patient Compliance; D010353:Patient Education as Topic; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control*; D013154:Spleen / Q000503:physiopathology*; D013156:Splenectomy / Q000009:adverse effects