Immunoprophylaxis in asplenic patients

INTERNATIONAL JOURNAL OF SURGERY

卷:7

Article

Harji, D. P.¹  Jaunoo, S. S.¹  Mistry, P.¹  Nesargikar, P. N.² 

[1] Worcestershire Royal Hosp, Dept Gen Surg, Worcester, England

[2] Univ Hosp N Staffordshire, Dept Gen Surg, Stoke On Trent, Staffs, England

关键词: Splenectomy;    Asplenic;    OPSI;    Overwhelming post-splenectomy sepsis;    Immunoprophylaxis;    Vaccinations;    Meningococcus;    Pneumococcus;    Haemophilus influenzae;    Capsulate organisms;   

DOI  :  10.1016/j.ijsu.2009.07.003

来源: Elsevier

【 摘 要 】

The asplenic patient is at risk of overwhelming post-splenectomy infection (OPSI) due to encapsulated bacteria, namely pneumococcus, haemophilus influenza B and meningococcal C pathogens. The lifetime risk is 1-2% with the estimated mortality being in the region of 40-70% (Davidson RN, Wall RA. Prevention and management of infections in patients without a spleen. Clin Microbiol Infect 2001; 7: 657-60). Preventative measures include appropriate prophylactic vaccination, long term antibiotics and patient education. Guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen were first published by the British Committee for Standards in Haematology in 1996, with a revised edition published in 2002. There are a number of permutations of these guidelines published by a number of professional bodies and consequently this has led to variable adherence rates to such guidelines. We review the perioperative administration of prophylactic vaccinations. (C) 2009 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

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