PREVENTION OF INFECTION AFTER SPLENECTOMY - WHAT PRECAUTIONS ARE REQUIRED

Removal of the spleen presents a lifelong risk of infection, in partic ular the syndrome of overwhelming postsplenectomy sepsis. Streptococcu s pneumoniae, Haemophilus influenzae and Neisseria meningitides are th e most common organisms involved, but malaria, babesiosis and DF-2 als o create a problem. Immunisation with pneumococcal vaccine, H. influen zae type b vaccine, influenza vaccine and, if in a high risk area, men ingococcal vaccine is recommended. Lifelong phenoxymethylpenicillin 25 0mg twice daily is also advised, especially in high risk groups such a s children and immunocompromised patients. If patients are unwilling t o take medicine lifelong, or are unlikely to comply, an antibiotic sup ply should be made available at all times and administration should co mmence at the first sign of illness. It is vital that patients who hav e had a splenectomy are properly informed of the hazards and the appro priate measures to be taken, including the risks of malaria and other less common infections.