Splenectomy may be necessary 2° to: 1) trauma 2) cancer (i.e multiple myeloma, ALL, CLL) 3) ITP refractory to treatment. Certain disease states may result in functional asplenia (i.e Sickle cell disease).
REMEMBER *SHIN* for encapsulated organisms:
Streptococcus pneumoniae
Haemophilus Influenzae
Neisseria meningitidis
NOTE: The risk of sepsis after splenectomy is highest in the first couple of years!
SPECIAL CONSIDERATION:
- Capnocytophaga canimorsus – Increased risk from cat and dog bites
- Babesia microti- Tick precautions when at risk for tick exposure in areas of risk
- Salmonella typhi- Leading cause of Osteomyelitis in Sickle Cell patients
REFERENCES
- Principles and Practice of Hospital Medicine. Chapter 198. Infections of the Immunocompromised Host. Sarah P. Hammond, MD; Lindsey R. Baden, MD
- 374: Primary Immune Deficiency Diseases. Harrison’s Principles of Internal Medicine, 19. Alain Fischer