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Meningitis after splenectomy.

C D Selby1, P J Toghill

  • 1Department of Medicine, University Hospital, Nottingham.

Journal of the Royal Society of Medicine
|April 1, 1989
PubMed
Summary
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Splenectomized patients face a high risk of Streptococcus pneumoniae meningitis. Prophylactic penicillin is recommended, but the effectiveness of the pneumococcal vaccine in preventing these infections remains uncertain.

Area of Science:

  • Infectious Diseases
  • Immunology
  • Microbiology

Background:

  • Splenectomy, the surgical removal of the spleen, significantly increases the risk of overwhelming post-splenectomy infection (OPSI).
  • Bacterial meningitis is a serious complication in asplenic individuals, often caused by encapsulated bacteria like Streptococcus pneumoniae.

Observation:

  • This study reviewed six episodes of bacterial meningitis in five splenectomized patients admitted to Nottingham hospitals between 1974 and 1985.
  • Streptococcus pneumoniae was identified as the causative agent in all documented cases.

Findings:

  • Only one patient had received the pneumococcal vaccine, and this patient survived.
  • Two patients died despite aggressive medical treatment, highlighting the severity of these infections.

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  • The infecting organism in all cases was Streptococcus pneumoniae.

    • Implications:

    • There is substantial evidence supporting the use of prophylactic penicillin in asplenic patients to prevent invasive pneumococcal disease.
    • The efficacy of the current pneumococcal vaccine in preventing meningitis in splenectomized individuals requires further investigation and potentially improved vaccine strategies.