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A Journal on Pediatrics, Neonatology, Adolescent Medicine,
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Minerva Pediatrica 2013 August;65(4):427-45

language: Italian

Update on prevention of infections in patients without spleen or with diminished splenic function

Miniero R. 1, Barretta M. 2, Dolceamore T. R. 2, De Luca G. 2, Altomare F. 1, Chiarello P. 3, Gentile I. 4, Saracco P. 5, Zurlo F. 1, Bona G. 6

1 Cattedra di Pediatria Università Magna Graecia di Catanzaro Catanzaro, Italia;
2 Pediatra di Famiglia, Società Italiana di Pediatria, Sezione Calabria;
3 Ospedale-ASP Crotone, Crotone, Italia;
4 Scuola di Specializzazione in Patologia Clinica Università Magna Graecia di Catanzaro Catanzaro, Italia;
5 Ematologia Pediatrica Università di Torino, Torino, Italia;
6 Cattedra di Pediatria Università Piemonte Orientale A. Avogadro, Novara, Italia


Patients without spleen or with diminished splenic function are at high risk (10-50 times higher than in normal population) of developing life-threatening infections (OPSI). Mortality from OPSI is estimated at 50 to 80% of cases. More frequent causative agents are encapsulated bacteria: Streptococcus Pneumoniae, Haemophilus influenzae type b and Neisseria Meningitidis. The risk of OPSI can be reduced by immunizing patients against these pathogens and by prescribing antibiotic prophylaxis. Continuous antibiotic prophylactic for 2-5 years after splenectomy (longer periods might expose the patients to the risk of antibiotic resistance) with penicillin or amoxicillin/clavulanate acid is mandatory. Asplenic individuals should take empirical antibiotic therapy — so called “self-treatment” — and immediate medical consultation in presence of febrile illness. All patients and their parents should be carefully educated about the risk of infections in order to obtain a good long-term compliance with these recommendations.

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