- Definition
- Rapidly progressive, life-threatening infection that occurs in individuals who have had their spleen removed (asplenia) or whose spleen is non-functional (functional asplenia). It is characterized by severe sepsis or septic shock and is primarily caused by encapsulated bacteria.
- Annual risk of 4% in children and <1% in adults
- Greatest risk is first 2 years post splenectomy.
- Due to
- Issue clearing encapsulated organisms: The spleen filters bloodborne pathogens, particularly encapsulated bacteria like:
- Streptococcus pneumoniae
- Haemophilus influenzae
- Neisseria meningitidis
- Impaired phagocytosis
- Decreased IgM
- Decreased opsonisation
- Common pathogens include streptococcus pneumoniae, H influenzae, N meningitis, E coli, Staph Aureus, Strep Pyogenes, and malaria.
- Clinically – very rapid progression
- Management
- Prevention - immunisation
- Urgent broad spectrum antibiotics, even before cultures
- Vancomycin, ceftriaxone, ciprofloxacin
- Or Meropenem if cephalosporin allergy
- Prophylactic Antibiotics
- Childeren and high risk adults
- Back pocket abx script
- Travel precautions to endemic malaria areas