The recent report by King and Shumacker,1 reviewing the incidence of infections after splenectomy, suggests that this common operation is likely to be followed by meningitis or sepsis when performed in early infancy. Their series comprised approximately 100 cases, but the age limits were not stated. Of five infants splenectomized under 6 months of age, four contracted meningitis (two meningococcal, one Hemophilus influenzae, and one of undetermined type) from 5 to 31 months following splenectomy, while the fifth died of an illness strongly suggesting septicemia 1 month after splenectomy. These authors were able to find one similar case in a careful review of the literature, although they refer to a communication from Dr. Colin Ferguson to the effect that nine infants splenectomized at the Children's Medical Center under 6 months of age were alive and well one to six years later and that one child with a splenectomy at 7\ m=1/ 2\ months of age died one year later of tracheobronchitis. Since so few data are available to confirm their conclusions that splenectomy in early infancy is followed by a high incidence of serious infection and death, we have been prompted to review the records of the years 1930-1954 at the Children's Medical Center, comprising some 200 splenectomies nearly all performed on children under 10 years of age. Essentially this is the group reviewed by Gross,2 with some additions and omis¬ sions ; cases were excluded in which the primary illness was a factor in susceptibility to infection (for example, leukemia) or in which some prior defect in the immune mechanism was known to exist, as in liver disease or nutritional failure.Of the 62 splenectomies performed for congenital hemolytic anemia during the period reviewed, 10 were performed in children under 6 months of age. In a post¬ operative follow-up period of three years, none of these, with the exception of the case mentioned by Ferguson, has had any difficulty. We have not been able to locate the record of this single exception. Two infants were only 2 months of age, four were 3-5 months, and four were 6 months of age when splenectomy was carried out. This indicates that splenectomy under 6 months of age is not invariably followed by serious infection. Seven infants were between 6 months and 1 year of age at the time of splenectomy for congenital hemolytic anemia, and they have also had an unevent¬ ful course. Thus in 17 children under one year of age with splenectomy for congenital hemolytic anemia there were no apparent untoward sequelae.Of the 45 remaining cases, only 1 so far as can be determined had any serious illness following splenectomy. Case 1.-A boy, born Dec. 24, 1934, was first ad¬ mitted to the Children's Medical Center in 1937because of pallor and weakness for two months and dysuria and red urine for one day. The family his¬ tory was negative for congenital hemolytic anemia. Examination revealed slight lymphadenopathy and palpable liver and spleen. The red blood cell count was 900,000, hemoglobin less than 20%, white blood ce...

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A team of students from the Department of Epidemiology and Public Health, Yale University School of Medicine, has been investigating an increase in reported infections with Neisseria gonorrhea statewide in children 13 years of age or less, excluding neonates, in Connecticut. In particular, there was a marked increase in reported infections in one city between 1983 and 1984. The results suggest that much of a statewide increase during that time may have been due to improved recognition, predominantly due to the use of pharyngeal cultures in this city, and raise disturbing questions about the adequacy of recognition, culturing, and reporting from other parts of the state.