Asplenia/Hyposplenia

Last updated 25.08.13

   

Definition

-     

 

Features

-  At risk from encapsulated bacteria

-  Meningococcus, heamophilus influenza, pneumococcus

- FBE & blood film: Howell-Jolly bodies

 

Causes

- Splenectomy

 

Management

-  Immunisations

-  At risk from encapsulated bacteria

-  Meningococcus, heamophilus influenza, pneumococcus

-  First vaccination 7-14 days prior to splenectomy or 7 days+ afterwards

-  Influenza annually

-  Pneumococcus: 0 (Prevnar 13), 8/12 (Pneumovax 23), 5yrs (Pneumovax 23)

-  Meningococcus (Menveo, Menactra): 0, 8/12+, 5yrs

-  Haemophilis influenzae type b (Hiberix): single vaccination, no boosters

-  Increased risk of Malaria infection

-  Victorian Spleen Registry (VSR)

-  (03) 9076 3828 or Registration Form .pdf or online

-  Confidential, yealrly newsletters, medical research, vaccination reminders

-  Vaccination & antibiotic guidelines

-  Prophylactic Abx

-  2yrs post removal+

-  If immunocompromised lifelong

-  If otherwise healthy 2yrs post splenectomy or lifelong

-  Amoxycillin 250-500mg PO Daily or Phenoxymethylpenicillin 250-500mg PO BD

- Penicillin allergy: Roxithromycin 150mg PO Daily or Erythromycin 250mg PO Daily

-  Emergency Abx if unwell or fever

-  Amoxycillin 3g PO Daily

-  Penicillin allergy: Roxithromycin 300mg PO Daily or Eryhtromycin 1g PO QID

-  Medical alert bracelet

-  Infection Post Splenectomy

-  Sepsis has 50% mortality rate

- Strep pneumoniae 50%

-  Haemophilus influenza type b

-  Neisseria meningitidis

-  Capnocytophaga canimorsus (dog or cat bites)

-  Highest risk in first 2yrs after removal

   

 

 

References


Victorian Spleen Registry (VSR) 

AFP: Postsplenectomy Infection - Strategie for Prevention in General Practice, Vol 39, No 6 June 2010