[Failure of anti-pneumococcal vaccination and prophylactic antibiotic therapy in 2 splenectomized subjects]

Asplenic patients are at high risk for the development of fulminant pneumococcal bacteremia. The mortality rate in those infected patients remains high. Therefore pneumococcal polysaccharide vaccine has been recommended, but despite penicillin prophylaxis pneumococcal sepsis can occur in vaccinated patients. We have observed two cases (one fatal) of overwhelming postsplenectomy pneumococcal sepsis in vaccinated patients who received long-term antibiotic prophylaxis. Both exhibited a poor antibody response to polyvalent vaccine.