Author/Editor		Jereb, Matjaž; Strunjaš, Natalija
Title		Življenjsko nevarne okužbe po splenektomiji
Translated title		Life threatening infection after splenectomy
Type		članek
Source		In: Gričar M, Vajd R, editors. Urgentna medicina: izbrana poglavja. Zbornik 13. mednarodni simpozij o urgentni medicini; 2006 jun 14-17; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year		2006
Volume		str. 266-71
Language		slo
Abstract		Hereditary or acquired asplenia is often followed by sepsis. It could be a result of surgical removal of spleen due to trauma, hypersplenism, malignances and immune and hematologic diseases (ie. hereditary spherocytosis, idiopathic thrombocytopenic purpura). Absence of the spleen could be hereditary or the spleen could be poorly performing (functional hyposplenism). That includes numerous autoimmune disorders, hematologic, neoplastic and intestinal diseases, and many other reasons such as alcoholism, bone marrow transplatation, hypopituitarism etc. Risk varies depending on cause of splenectomy. The lowest risk is related to trauma, idiopathic thrombocytopenic purpura, intermediate to spherocytosis, portal hypertension and Hodgkin's disease. The highest risk regards patients with thalassemia. Infections more often affect children and risk is the highest in first few years after the splenectomy. Postsplenectomy sepsis is proceeds rapidly, clinical symptoms and signs are often untypical. Clinical demonstrable site of infection usually can not be determined in adults. In children, however, focal infections ie. meningitis are more prominent. The most common cause of postsplenectomy sepsis is Streptococcus pneumoniae. Mortality rate for these patient is extremely high, sometimes even 600 times higher then in healthy persons and it's not related to cause of asplenia. Early treatment is crucial for the outcome. For asplenic patients, even the slightest suspicion of systemic bacterial infection is enough for emergency medical treatment, beginning of widespectrum antimicrobial therapy and admitting in hospital. Prevention has a very important role. Prophylactic antimicrobials, vaccination against pnemococci, Haemophilus influenzaetype b in meningococci as well as physician, patient and family education are important elements in decreasing the risk of sepsis.
Descriptors		SPLENECTOMY SEPSIS STREPTOCOCCUS PNEUMONIAE HAEMOPHILUS INFLUENZAE