Pneumococcal vaccine in patients with absent or dysfunctional spleen

Four patients (3 long-term Hodgkin disease survivors and 1 recipient of an allogeneic bone marrow transplant) developed severe infections with Strepto coccus pneumoniae after staging splenectomy or due to functional hypospleni sm after total body irradiation and bone marrow transplantation. Current gu idelines for prevention of infection recommend pneumococcal immunization fo r patients with Hodgkin disease treated with splenectomy and others with fu nctional hyposplenism. Booster vaccination after 5 years is also advised. H ospital- and community-based vaccination initiatives may help identify at-r isk patients.