[Splenectomy and pneumococcal septicemia]

A literature review, following the observation of 4 cases of pneumococcal septicemia in splenectomized patients, demonstrated that infection was frequent in subjects with functional or anatomical asplenia, usually in the form of a pneumococcal septicemia. Infection occurs one hundred times more frequently in splenectomized patients than in the general population. The risk of developing an infection varies from one patient to another, and is related to the motive for splenectomy, the period since operation, and the age of the patient at the time of surgery. Pneumococcal septicemia in such cases is distinguished by its insidious nature and its very poor prognosis, the outcome being fatal in 50 to 70 p. cent of cases. This justifies intensive prophylactic measures: partial splenectomy, heterotopic transplantation, anti-pneumococcal vaccination, and long-term antibiotic therapy. None of these methods offers absolute protection, and indications for splenectomy should therefore be limited to the strict minimum.