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Fulminant pneumococcal infections in 'normal' asplenic hosts

V Gopal, A L Bisno

    Archives of Internal Medicine
    |November 1, 1977
    PubMed

    Insights

    Asplenic individuals face a heightened risk of severe pneumococcal infections, particularly after splenectomy. Prompt antibiotic treatment for fevers and potential vaccination are crucial for prevention.

    Area of Science:

    • Infectious Diseases
    • Immunology
    • Clinical Medicine

    Background:

    • Splenectomy, the surgical removal of the spleen, is performed for various reasons including trauma and congenital abnormalities.
    • The spleen plays a vital role in the immune system, particularly in clearing encapsulated bacteria like Streptococcus pneumoniae.
    • Asplenic individuals are known to be at increased risk for severe infections.

    Observation:

    • Five otherwise healthy asplenic individuals presented with overwhelming pneumococcemia.
    • Four patients had undergone splenectomy for trauma; one had congenital asplenia.
    • This adds to at least 26 reported cases of life-threatening pneumococcal infections in asplenic patients.

    Findings:

    • Splenectomy is associated with an increased risk of overwhelming pneumococcal disease.
    • While the overall risk is low, the mortality rate for these infections is high.
    • Certain pneumococcal serotypes, notably type XII, are frequently implicated.

    Implications:

    • Undiagnosed febrile episodes in asplenic individuals require prompt antibiotic treatment pending culture results.
    • This treatment strategy should be applied universally, irrespective of patient age or general health.
    • Pneumococcal vaccination, potentially targeting specific prevalent serotypes, may be highly effective in preventing these severe infections.

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