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SPLENECTOMY & S. PNEUMONIAE

Infectious Diseases

SPLENECTOMY & S. PNEUMONIAE

1. You need a functioning spleen and an ability to make antibodies to defend against encapsulated S. pneumoniae and H. influenzae.

2. So both infections are seen more often in asplenic patients (including those with sickle cell [SS] disease), very young and old patients, and in CLL, MM, and agammaglobulinemia.

3. Alcoholics also are more susceptible, but not because of antibody problems.

4. Post-splenectomy pneumococcal sepsis presents as nonspecific sepsis, purpura, and DIC. It can be rapidly fatal.

5. Howell-Jolly bodies, indicative of the asplenic state, are often seen on peripheral smear.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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