Overwhelming post-splenectomy infection

Overwhelming post-splenectomy infection
Other namesOverwhelming post-splenectomy sepsis (OPSS)[1]
SpecialtyInfectious disease
Usual onset24–48 hours following presentation with mild viral symptoms[2]
CausesExposure to pathogens following splenectomy or asplenia
Risk factorsSplenectomy in the past 2–3 years, removal of spleen for hematological reasons, being under the age of 2[2]
PrognosisAlmost invariably fatal without treatment[2]

An overwhelming post-splenectomy infection (OPSI) is a rare but rapidly fatal infection occurring in individuals following removal (or permanent dysfunction) of the spleen. The infections are typically characterized by either meningitis or sepsis, and are caused by encapsulated organisms including Streptococcus pneumoniae.[3] It is a medical emergency and requires immediate treatment. Death has been reported to occur within 12 hours.[4]

The spleen is necessary for protection against encapsulated bacteria (see Mechanism) and as such when removed by splenectomy it can lead to rapid unchallenged infection by encapsulated bacteria. The rapid progression from mild viral symptoms to sepsis is one of the things that makes OPSI particularly dangerous.

Another source of infection[5] are species of Babesia, which are tick-borne parasites that cause babesiosis.[6]

  1. ^ surgical recall, seventh edition, Lorne H. Blackbourne, page 469.
  2. ^ a b c Luu, Sarah; Spelman, Denis; Woolley, Ian J. (2019). "Post-splenectomy sepsis: preventative strategies, challenges, and solutions". Infection and Drug Resistance. 12: 2839–2851. doi:10.2147/IDR.S179902. ISSN 1178-6973. PMC 6748314. PMID 31571940.
  3. ^ Waghorn DJ (March 2001). "Overwhelming infection in asplenic patients: current best practice preventive measures are not being followed". Journal of Clinical Pathology. 54 (3): 214–8. doi:10.1136/jcp.54.3.214. PMC 1731383. PMID 11253134.
  4. ^ Cite error: The named reference :0 was invoked but never defined (see the help page).
  5. ^ Rosner, F. (April 1984). "Babesiosis in splenectomized adults. Review of 22 reported cases". American Journal of Medicine. 76 (4): 696–701. doi:10.1016/0002-9343(84)90298-5. PMID 6424470.
  6. ^ Centers for Disease Control and Prevention. "About Babesiosis". CDC Parasites. Retrieved 19 June 2018.