Asplenia and Encapsulated Bacteria

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:

1. Capnocytophaga canimorsus – Increased risk from cat and dog bites
2. Babesia microti- Tick precautions when at risk for tick exposure in areas of risk 
   
3. Salmonella typhi- Leading cause of Osteomyelitis in Sickle Cell patients

REFERENCES

1. Principles and Practice of Hospital Medicine.  Chapter 198. Infections of the Immunocompromised Host. Sarah P. Hammond, MD; Lindsey R. Baden, MD
2. 374: Primary Immune Deficiency Diseases. Harrison’s Principles of Internal Medicine, 19. Alain Fischer