Incidence of Serious Infections After Splenectomy in Childhood

Konigswieser, H.; Brandeis, W. E.; Gharib, Mohammad Hadi; Gdanietz, K; Holschneider, A. M.; Jürgenssen, O. A.; Lohr, James W.; Tischer, W; Urban, Ch.; Wählby, L; Wuring, P.

doi:10.1007/978-3-642-70276-1_24

Cited by 13 publications

(2 citation statements)

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“…Splenectomized patients are reported to be at higher risk for developing rapidly progressive, lethal septic shock due to overwhelming bacterial infection (24–26). In this study, we show, however, that splenectomy does not impair bacterial clearance or worsen survival during polymicrobial abdominal sepsis treated with antibiotics.…”

Section: Discussionmentioning

confidence: 99%

Splenectomy Protects against Sepsis Lethality and Reduces Serum HMGB1 Levels

Huston¹,

Wang

Ochani³

et al. 2008

The Journal of Immunology

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High mobility group box 1 (HMGB1) is a critical mediator of lethal sepsis. Previously, we showed that apoptotic cells can activate macrophages to release HMGB1. During sepsis, apoptosis occurs primarily in lymphoid organs, including the spleen and thymus. Currently, it is unclear whether this accelerated lymphoid organ apoptosis contributes to systemic release of HMGB1 in sepsis. In this study, we report that splenectomy significantly reduces systemic HMGB1 release and improves survival in mice with polymicrobial sepsis. Treatment with a broad-spectrum caspase inhibitor reduces systemic lymphocyte apoptosis, suppresses circulating HMGB1 concentrations, and improves survival during polymicrobial sepsis, but fails to protect septic mice following splenectomy. These findings indicate that apoptosis in the spleen is essential to the pathogenesis of HMGB1-mediated sepsis lethality.

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Section: Discussionmentioning

confidence: 99%

Splenectomy Protects against Sepsis Lethality and Reduces Serum HMGB1 Levels

Huston¹,

Wang

Ochani³

et al. 2008

The Journal of Immunology

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“…Following splenectomy the risk of overwhelming infections is increased [2][3][4][5][6]; 93% of infections occur during the first 3 years after splenectomy [2] and continuous oral penicillin prophylaxis is recommended for this period. However, even years after splenectomy sepsis can occur [7].…”

Section: Introductionmentioning

confidence: 99%

Frequency of very late fatal sepsis after splenectomy for hereditary spherocytosis: impact of insufficient antibody response to pneumococcal infection

Eber

Langendörfer

Ditzig

et al. 1999

Annals of Hematology

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Very late sepsis in splenectomized patients with hereditary spherocytosis has been seen rarely up to now; the frequency and the immunodeficiency causing it are largely unknown. Within the past 7 years we have learned of four cases of sepsis or meningitis (three fatal) in adult patients with hereditary spherocytosis who had been splenectomized years earlier. The estimated frequency of very late postsplenectomy infections is 0.69 cases of sepsis or meningitis in 1000 patient-years (0.46 deaths in 1000 patient-years). Pneumococci were proven in two patients. The surviving patient showed low antibody titers against pneumococcal serotypes even after pneumococcal meningitis and subsequent vaccination. There have been several reports of an insufficient response to pneumococcal vaccination in patients with severe infections. We recommend determination of pneumococcal antibody titers after immunization in every splenectomized patient: Nonresponders to vaccination may be at high risk for overwhelming postsplenectomy infection. Our data demonstrate that there is a lifelong risk for severe postsplenectomy infections and therefore the lasting need for immediate antibiotic therapy in any case with sudden onset of high fever.

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