Overwhelming post splenectomy infection syndrome – Review study

Sinwar, Prabhu Dayal

doi:10.1016/j.ijsu.2014.11.005

Cited by 142 publications

(129 citation statements)

References 22 publications

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“…Meningitis and pneumonia are often associated in the more severe stages. The patient's clinical state can quickly deteriorate, leading to coma and death (7). There is a lifelong risk for developing OPSI with the highest incidence in the first two years post-splenectomy (8).…”

Section: Infectious Risksmentioning

confidence: 99%

Patients After Splenectomy: Old Risks and New Perspectives

Dragomir¹,

Petrescu²,

Manga³

et al. 2016

chr

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Rezumat Pacienåii post-splenectomie: complicaåii cunoscute aei perspective noiComplicaåiile care survin în urma splenectomiei pot fi împãråite în infecåioase aei non-infecåioase. Legãtura dintre splenectomie aei aceste riscuri este doar paråial înåeleasã. Rãspunsul imun al gazdei împotriva infecåiei este profund modificat post-splenectomie, iar aceaeti indivizi sunt mai susceptibili sã dezvolte sepsis aei infecåia are o evoluåie fulminantã. Splenectomia este de asemenea un potenåial factor de risc pentru numeroase complicaåii vasculare care rezultã în urma obstrucåiei paråiale sau totale ale unei artere sau vene. În plus, hipertensiunea pulmonarã poate fi o complicaåie severã aei uneori fatalã a splenectomiei. Unii autori includ aei neoplaziile, diabetul zaharat aei pancreatita acutã în categoria complicaåiilor non-infecåioase post-splenectomie. Cea mai de temut complicaåie pentru pacienåii splenectomizaåi rãmâne sepsisul. Fiziopatologia sepsisului încã este controversatã. Decesul în sepsis poate surveni fie în urma hiperinflamaåiei, fie în urma imunosupresiei. Multiple dovezi experimentale au dovedit implicarea microRNA-urilor celulare aei virale în sepsis. Considerãm faptul cã microRNA-urile sunt de asemenea asociate cu imunosupresia pacientului asplenic, ceea ce determinã o creaetere a riscului de sepsis fatal. Studierea nivelului expresiei plasmatice a microRNA-urilor circulante la pacienåii asplenici, ar putea conduce la o mai bunã înåelegere a imunosupresiei post-splenectomie aei la dezvoltarea unor noi metode diagnostice aei terapeutice.Cuvinte cheie: splenectomie, microRNA, sepsis, microRNA-uri virale, OPSI AbstractThe risks that arise after splenectomy can be divided in infectious and non-infectious. The link between splenectomy and these hazards remains partially unknown. Host defense against infection is altered after splenectomy and such individuals develop sepsis more easily and the infection has a fulminant course. Splenectomy is also a potential risk factor for several vascular complications that result from partial or total obstruction of an arterial or venous blood vessel. Furthermore, pulmonary hypertensioncan be a severe and sometimes fatal complication following splenectomy. Some authors also consider that malignancies, diabetes mellitus and acute pancreatitis are non-infectious complications after splenectomy. The most feared complication for splenectomized patients remains sepsis. The pathophysiology of sepsis is still controversial. Death in sepsis can occur due to either hyper-inflammation or "immune paralysis". Multiple experimental evidences link cellular and viral microRNAs with sepsis. We presume that General ReportChirurgia (2016)

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Section: Infectious Risksmentioning

confidence: 99%

Patients After Splenectomy: Old Risks and New Perspectives

Dragomir¹,

Petrescu²,

Manga³

et al. 2016

chr

View full text Add to dashboard Cite

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“…The predominant organisms responsible for overwhelming sepsis in splenectomized patients are pneumococci (50%), meningococci, and Hemophilus influenza. OPSI is a dangerous process that carries a high mortality rate (12,13).…”

Section: Discussionmentioning

confidence: 99%

“…It has been customary to attempt immunization either 2 weeks before or 2 weeks after splenectomy to enhance immunogenicity (14). Vaccines available for the most common organisms include the 23-valent pneumococcal polysaccharide vaccine, a 7-valent proteinconjugated pneumococcal vaccine, the Hemophilus influenzae type B vaccine, and the meningococcal vaccine (12,13). The presented patient received vaccination on the 12 th postoperative day.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous splenic artery aneurysm rupture in a 38-year old female: a case report

Koutserimpas¹,

Papachristou²,

Nikitakis³

et al. 2017

GHIR

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“…The Centers for Disease Control and Prevention recommends the administration of pneumococcal vaccines for asplenic patients; this vaccine protects patients against 73-90% of strains causing postsplenectomy infections [22]. Other guidelines also recommend that patients with asplenia or hyposplenia be immunized against organisms including S. pneumoniae, H. influenzae type b, and N. meningitidis [22,23].…”

Section: Discussionmentioning

confidence: 99%

“…Other guidelines also recommend that patients with asplenia or hyposplenia be immunized against organisms including S. pneumoniae, H. influenzae type b, and N. meningitidis [22,23]. When a person is incidentally found to have splenic hypoplasia, vaccination against S. pneumoniae to prevent the devastating disease of purpura fulminans may need to be considered.…”

Section: Discussionmentioning

confidence: 99%

Streptococcus pneumoniae induced purpura fulminans in a patient with splenic hypoplasia

Kojima¹,

Hiraoka²,

Ehara³

et al. 2017

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. Case Report: A 57-year-old male was presented to our emergency department in shock state with flu-like symptoms. Empirical broad-spectrum antibiotics and intensive care were started. His condition rapidly deteriorated with multiple organ failure. Blood culture grew up S. pneumoniae. Purpuric skin change developed in all extremities followed by ischemic gangrene, which required amputation. He did not have any history of immunosuppressive disease. His computed tomography scan of abdomen showed small size of spleen. Howell-Jolly bodies were recognized in peripheral blood smear. The patient was finally diagnosed with purpura fulminans with overwhelming pneumococcal sepsis. Although he had no history of immunodeficiency, he had evidence of Howell-Jolly bodies in peripheral blood smear, implying reduced splenic function, possibly due to splenic hypoplasia. To prevent this devastating condition, vaccination against S. pneumoniae may need to be considered for people with splenic hypoplasia. IJCRI publishes Conclusion:Since delay in therapy would lead to a poor outcome, clinicians should be alert to purpura fulminans in patients in shock state, even lacking typical skin manifestation initially. Splenic hypoplasia may be a risk factor of this condition.

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Overwhelming post splenectomy infection syndrome – Review study

Cited by 142 publications

References 22 publications

Patients After Splenectomy: Old Risks and New Perspectives

Patients After Splenectomy: Old Risks and New Perspectives

Spontaneous splenic artery aneurysm rupture in a 38-year old female: a case report

Streptococcus pneumoniae induced purpura fulminans in a patient with splenic hypoplasia

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