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Vaccination splenectomy

Umut Gazi, Djursun Karasartova, Ibrahim Tayfun Sahiner, Ayse Semra Gureser, Ozgur Tosun, Mehmet Kursat Derici, Mete Dolapci, Aysegul Taylan Ozkan
AIM: Splenectomised patients are associated with lifelong risk of fatal overwhelming post-splenectomy infection (OPSI), which is mostly caused by Streptococcus pneumoniae. Today OPSI cases can still be reported even in patients with appropriate vaccination. In our study, the levels of vaccine-specific memory B- and T cells were compared between control and splenectomised patients to enlighten the underlying reason. MATERIALS AND METHODS: Five healthy and 14 post-traumatic splenectomised individuals were vaccinated with 13-valent pneumococcal conjugate vaccine (PCV-13) followed by 23-valent pneumococcal polysaccharide vaccine (PPV-23)...
March 13, 2018: International Journal of Clinical Practice
Alicia Arnott, Penelope Jones, Lucinda J Franklin, Denis Spelman, Karin Leder, Allen C Cheng
Background: Overwhelming post-splenectomy infection (OPSI) is a serious complication of asplenia. Clinical guidelines recommend a number of measures to reduce the risk of OPSI, but awareness and adherence to preventative measures is generally poor. We aimed to determine whether a registry for asplenic/hyposplenic patients was associated with a reduction in the incidence of infection with encapsulated bacteria. Methods: We performed a retrospective cohort study of asplenic/hyposplenic patients in the state of Victoria, Australia who registered with Spleen Australia from 2003 - 2014...
February 17, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Hanh D Vo, Diana F Florescu, Cindy R Brown, Heather E Chambers, David F Mercer, Luciano M Vargas, Wendy J Grant, Alan N Langnas, Ruben E Quiros-Tejeira
Children undergoing LSBPTx are at increased risk of IPI due to splenectomy. We aimed to describe the clinical features and outcomes of IPI in pediatric LSBPTx recipients. Between 2008 and 2016, 122 LSBPTx children at our center were retrospectively reviewed. Nine patients had 12 episodes of IPI; the median age at first infection was 3.5 years (range: 1.5-7.1 years). The median time from transplant to first infection was 3 years (range: 0.8-5.8 years). Clinical presentation included as follows: pneumonia (n = 1), bacteremia/sepsis (n = 7), pneumonia with sepsis (n = 1), meningitis with sepsis (n = 2), pneumonia and meningitis with sepsis (n = 1)...
February 13, 2018: Pediatric Transplantation
Chamath Premawardena, Donald Bowden, Zane Kaplan, Claire Dendle, Ian John Woolley
OBJECTIVES: Asplenia and hyposplenism carry a significant risk of ongoing morbidity and mortality which can be reduced by education, vaccination and antibiotic use. We aimed to assess education and other methods of prevention in a cohort of patients with haemoglobinopathy in a tertiary referral centre, which also had access to a post-splenectomy registry created to reduce post-splenectomy infection risk. METHODS: A standardized questionnaire was used on patients who attended the service for regular therapy...
December 13, 2017: Hematology (Amsterdam, Netherlands)
Aaron R Alvarado, Kahdi Udobi, Stepheny Berry, Jaynell Assmann, Tracy McDonald, Robert D Winfield
BACKGROUND: Splenectomies are common after abdominal trauma, and measures must be taken to prevent infection, namely, the administration of available conjugate vaccinations against encapsulated organisms. While initial immunization is frequently completed prior to discharge, the Advisory Council on Immunization Practices recommends administration of an 8-week vaccination booster against S. pneumoniae, and compliance with this practice is unknown. We hypothesized that patients undergoing splenectomy for trauma would not routinely receive the recommended immunization and subsequent booster...
February 2018: Surgery
Lucian Visan, Nicolas Rouleau, Emilie Proust, Loïc Peyrot, Arnaud Donadieu, Martina Ochs
Currently marketed Streptococcus pneumoniae (Spn) vaccines, which contain polysaccharide capsular antigens from the most common Spn serotypes, have substantially reduced pneumococcal disease rates but have limited coverage. A trivalent pneumococcal protein vaccine containing pneumococcal choline-binding protein A (PcpA), pneumococcal histidine triad protein D (PhtD), and detoxified pneumolysin is being developed to provide broader, cross-serotype protection. Antibodies against detoxified pneumolysin protect against bacterial pneumonia by neutralizing Spn-produced pneumolysin, but how anti-PhtD and anti-PcpA antibodies protect against Spn has not been established...
November 14, 2017: Human Vaccines & Immunotherapeutics
Ho Hui Lian, Firdaus Hayati, Aishath Azna Ali, Nornazirah Azizan, Mohd Firdaus Che Ani, Muhammad Aznan Suhaili, Andee Dzulkarnaen Zakaria
We present the case of a 16-year-old boy presented with two weeks episode of worsening lower abdominal pain. Clinically, there was a tender palpable mass on the suprapubic region. Ultrasonography showed an absent spleen at its usual area, instead might represent the suprapubic mass. An emergency laparotomy revealed a congested spleen in the pelvic cavity. Splenectomy was undertaken as it was non-viable. The patient was discharged uneventfully with triple vaccinations. We describe this unique entity with its literature review...
October 24, 2017: Folia Morphologica (Warsz)
Shih-Wei Lai, Cheng-Li Lin, Kuan-Fu Liao
BACKGROUND: People without a spleen are particularly susceptible to various overwhelming infections including pneumonia. Although the association between splenectomy and pneumonia has been previously studied, there has been no study using the national claims data. OBJECTIVES: The aim of the study was to investigate the association between splenectomy and pneumonia. DESIGN: A retrospective population-based cohort analysis. SETTINGS: Database of the Taiwan National Health Insurance Program...
September 2017: Annals of Saudi Medicine
Janaiara A Cunha, Leonardo J M Carvalho, Cesare Bianco-Junior, Márcia C R Andrade, Lilian R Pratt-Riccio, Evelyn K P Riccio, Marcelo Pelajo-Machado, Igor J da Silva, Pierre Druilhe, Cláudio Tadeu Daniel-Ribeiro
A major constraint in the study of Plasmodium falciparum malaria, including vaccine development, lies on the parasite's strict human host specificity and therefore the shortage of animal experimental models able to harbor human plasmodia. The best experimental models are neo-tropical primates of the genus Saimiri and Aotus, but they require splenectomy to reduce innate defenses for achieving high and consistent parasitemias, an important limitation. Clodronate-liposomes (CL) have been successfully used to deplete monocytes/macrophages in several experimental models...
2017: Frontiers in Cellular and Infection Microbiology
Akshat Saxena, Winston Liauw, David L Morris
BACKGROUND: There is a paucity of data on the impact of splenectomy on peri-operative outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). We report the largest series to date which addresses this topic. METHODS: Nine hundred and thirty six consecutive patients underwent CRS/HIPEC from 1996 to 2016 at a high-volume institution in Sydney, Australia. Of these, 418 (45%) underwent splenectomy. Peri-operative complications were graded according to the Clavien-Dindo Classification...
August 2017: Journal of Gastrointestinal Oncology
Masamichi Komatsu, Toru Ishihara, Saki Manabe, Kosuke Kuwano, Masayuki Oki, Hidetaka Yanagi, Hideki Ozawa, Atsushi Takagi
Severe infection in patients who have lost splenic function is called overwhelming postsplenectomy infection (OPSI). Untimely treatment of patients with OPSI results in critical conditions with mortality rates as high as 50 %-70 %. For patients who undergo a splenectomy, vaccination is recommended for the prevention of OPSI. However, in Japan, the vaccination utilization rates are low. Herein, we report a case of OPSI caused by Streptococcus pneumoniae with a fulminant purpura resulting in multi-organ failure, which could be reversed by intensive care...
September 20, 2017: Tokai Journal of Experimental and Clinical Medicine
Antonio Di Sabatino, Marco Vincenzo Lenti, Francesco Paolo Tinozzi, Marina Lanave, Ivana Aquino, Catherine Klersy, Piero Marone, Carlo Marena, Andrea Pietrabissa, Gino Roberto Corazza
Splenectomy is a well-recognised risk factor for life-threatening overwhelming post-splenectomy infection (OPSI). To prevent OPSI, immunisations against encapsulated bacteria (S. pneumoniae, N. meningitidis, H. influenzae) and influenza virus are recommended. However, there is still a lack of uniformity and poor compliance with these recommendations. Following a local physicians' awareness campaign regarding the importance of vaccine prophylaxis of splenectomised patients, we aimed to register vaccination coverage, mortality and infection rates in all patients who underwent splenectomy at our hospital, over a six-year time span...
December 2017: Internal and Emergency Medicine
Ruth M Carrico, Linda Goss, Jodi Wojcik, Kimberly Broughton-Miller, Karina Pentecost, Michelle Frisbie, Stanley Kotey, Deborah Niyongabo, Matthew Benns, Anupama Raghuram, M Cynthia Logsdon
BACKGROUND AND PURPOSE: Patients undergoing splenectomy for trauma are at life-long risk for rapidly progressive septicemia. The purpose of this study was to investigate long-term patient understanding and follow-up with recommendations regarding their asplenia. METHODS: Patients undergoing splenectomy for trauma January 2010-December 2014 were analyzed. Medical records were reviewed and telephone follow-up interviews were conducted in October-December 2015. Patients were asked a standard set of questions that included hospitalizations, awareness of infectious risks associated with asplenia, need for revaccination, and vaccines they had received since their index hospitalization...
October 2017: Journal of the American Association of Nurse Practitioners
Teny Tjitra Sari, Arwin Ali P Akib, Djajadiman Gatot, Alida Roswita Harahap, Saptawati Bardosono, Sri Rezeki S Hadinegoro
INTRODUCTION: Streptococcus pneumoniae is a capsulated bacterium that can cause severe infection in patients with thalassemia major, particularly those who have undergone splenectomy. The absence of the spleen as well as zinc deficiency in splenectomized patients with thalassemia major increases the possibility of developing invasive pneumococcal infection. The aims of this study are to evaluate pneumococcal IgG levels following PCV and PPV immunizations and the effect of zinc supplementation on qualitative specific immune responses in splenectomized patients with thalassemia...
July 13, 2017: Vaccine
Victoria Birlutiu, Rares Mircea Birlutiu
RATIONALE: Hemophagocytic lymphohistiocytosis (HLH) is a syndrome that is characterized by an inappropriate hyperinflammatory immune response - primary, as a consequence of a genetic defect of NK cells and cytotoxic T lymphocytes or - secondary, in the progression of infections, rheumatic or autoimmune diseases, malignancies or metabolic diseases. PATIENT CONCERNS: We present the case of a secondary HLH due to Streptococcus pneumoniae infection in a splenectomised patient for spherocytosis, a 37-year-old patient who was splenectomised in childhood for spherocytosis, without immuneprophylaxis induced by antipneumococcal vaccine...
July 2017: Medicine (Baltimore)
Rodolfo J Oviedo, Andrew A Glickman
INTRODUCTION: The spleen is the most commonly injured intra-abdominal solid organ following blunt trauma. B-cell chronic lymphocytic leukemia (CLL) is the most common leukocytic dyscrasia affecting adults in Western countries. Splenomegaly with axillary and retroperitoneal lymphadenopathy are common physical findings. This case investigates an emergency splenectomy in a community hospital involving a 45-year-old man with blunt abdominal trauma following an assault with incidental splenomegaly and axillary lymphadenopathy, with surgical pathology findings of B-cell CLL...
2017: International Journal of Surgery Case Reports
Josef Singer, Christoph Testori, Peter Schellongowski, Ammon Handisurya, Catharina Müller, Eva-Maria Reitter, Wolfgang Graninger, Paul Knöbl, Thomas Staudinger, Stefan Winkler, Florian Thalhammer
BACKGROUND AND CASE PRESENTATION: We report a case of septic shock syndrome caused by Streptococcus pneumoniae in a patient who had undergone splenectomy due to an autoimmune lymphoproliferative syndrome (ALPS), which is characterized as a dysfunction of immunoregulation. Although the patient was vaccinated with a conjugated polysaccharide vaccine after the splenectomy, he was still susceptible to S. pneumoniae infection, because the isolated serovar (24F), a serovar long thought to be apathogenic, is not covered by any vaccine currently approved, neither a conjugated nor an unconjugated polysaccharide one...
June 22, 2017: BMC Infectious Diseases
Brandon Dionne, Walter Dehority, Meghan Brett, Thomas R Howdieshell
BACKGROUND: Splenic injury can occur through multiple mechanisms and may result in various degrees of residual immunocompetence. Functionally or anatomically asplenic patients are at higher risk for infection, particularly with encapsulated bacteria. Vaccination is recommended to prevent infection with these organisms; however, the recommendations are routinely updated, and vaccine selection and timing are complex. METHODS: Review of the pertinent English-language literature, including the recommendations of the U...
July 2017: Surgical Infections
Djursun Karasartova, Umut Gazi, Ozgur Tosun, Ayse S Gureser, Ibrahim T Sahiner, Mete Dolapci, Aysegul T Ozkan
PURPOSE: Splenectomy is associated with increased risk of overwhelming post-splenectomy infections despite proper anti-pneumococcal vaccination. As most studies concentrated on vaccination-induced humoral immunity, the cellular immune responses triggered in splenectomized patients are not yet well studied. The present study aims to investigate this area as it can contribute to the development of more effective vaccination strategies. METHODS: Five healthy and 14 splenectomized patients were vaccinated with pneumococcal conjugate polysaccharide vaccine (PCV) followed by pneumococcal polysaccharide vaccine according to the guidelines established by Advisory Committee on Immunization Practices...
May 2017: Journal of Clinical Immunology
Lindsey Rihtarchik, Claire V Murphy, Kyle Porter, Lisa Mostafavifar
PURPOSE: Asplenic patients are at increased risk for post-splenectomy infection caused by Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type B (Hib), and vaccination rates against these organisms remain low. The purpose of this study was to evaluate vaccination rates before and after implementation of a pharmacist-driven electronic vaccination tracking system. METHODS: This retrospective cohort analysis compared adult splenectomy patients before and after implementation of a pharmacist-driven tracking system with a primary outcome of complete initial vaccination...
April 24, 2017: Research in Social & Administrative Pharmacy: RSAP
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