Overwhelming post-splenectomy infection

The Postsplenektomie syndrome ( OPSI syndrome, Eng. Overwhelming postsplenectomy infection syndrome ) is a special variant of a bacterial infection after surgical removal of the spleen ( splenectomy ). The syndrome is associated with 1-5 % relatively frequently and with a high mortality rate of 38-69 %. Cause a specific, isolated macrophages in the absence of disturbance of the spleen, which results in a limited response capacity of infections with bacteria bekapselten. The loaded with antibodies bacteria capsules are no longer sufficient phagocytosed by these phagocytes, which are particularly in the spleen. The most common with 50-90 % of cases bacterium that causes a OPSI syndrome, especially in children, is Streptococcus pneumoniae ( pneumococcus ). Other pathogens are Haemophilus influenzae type b and Neisseria meningitidis. Rarely are Ehrlichia species or protozoa of the genus Babesia. The infection is always in the form of sepsis.

The OPSI syndrome may occur after splenectomy few days or several years. The yearly frequency of splenectomized patients to develop a OPSI syndrome, is 0.23 to 0.42 %; about 1-5 % of patients are affected throughout their lives it. Very often develops on the bottom of the disease, a Waterhouse Friderichsen syndrome.

As prophylaxis can be vaccinated against the most common pathogens bekapselten and continuously available ( stand-by antibiotic treatment ) or permanent treatment can be performed with antibiotics.

Swell

  • T. Okabayashi and K. Hanazaki: Overwhelming postsplenectomy infection syndrome in adults - A Clinically preventable disease. World J. Gastroenterology (2008 ) 14 ( 2): pp. 176-179 PMID 18186551
  • RN Davidson and RA Wall: Prevention and management of infections in patients without a spleen. Clin Microbiol Infect. (2001 ) 7 ( 12): pp. 657-660 PMID 11843905
  • Engelhardt et al.: Prevention of infection and thrombosis after splenectomy or functional loss of the spleen (DMW 2009)
  • Disease in visceral surgery
  • Bacterial infectious disease of humans
  • Bacterial infectious disease in animals
  • Spleen
Pathogenic bacteria Waterhouse–Friderichsen syndrome
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