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Vaccination splenectomy

Giuseppe La Torre, Alice Mannocci, Vittoria Colamesta, Valeria D'Egidio, Cristina Sestili, Antonietta Spadea
BACKGROUND: The risk of getting influenza and pneumococcal disease is higher in cancer patients, and serum antibody levels tend to be lower in patients with hematological malignancy. OBJECTIVE: To assess flu and pneumococcal vaccinations efficacy, effectiveness, and safety in onco-hematological patients. METHODS: Two systematic reviews and possible meta-analysis were conducted to summarize the results of all primary study in the scientific literature about the flu and pneumococcal vaccine in onco-hematological patients...
2016: Mediterranean Journal of Hematology and Infectious Diseases
Christian Georg Blumentrath, Nils Ewald, Jasmina Petridou, Uwe Werner, Barbara Hogan
The overwhelming post splenectomy infection (OPSI) in splenectomised patients is a rare but severe infection mostly caused by encapsulated bacteria. We analyse the case of a 65-year-old female patient who was presented with clinical and laboratory findings indicating gastroenteritis. Two years years before admission, the patient underwent a splenectomy for a two stage splenic rupture following resuscitation for pulmonary embolism. Immunisation of the patient was complete and timely. As a result of the unspecific clinical presentation, there was a delay in administration of antibiotics...
2016: German Medical Science: GMS E-journal
Thomas J Marrie, Gregory J Tyrrell, Sumit R Majumdar, Dean T Eurich
OBJECTIVES: Most are aware of pneumococcal infection as a complication of splenectomy and the increased risk of severe invasive pneumococcal disease (IPD) in asplenic patients. However little is known of the current status of this entity in a population with an active pneumococcal conjugate vaccine program for children. METHODS: All IPD cases reported from 2000 to 2014 in Northern Alberta, Canada were collected prospectively. Socio-demographic variables, clinical characteristics, and IPD-related outcomes were compared between patients with and without a spleen using the Student t-test, Chi-square test, or Fisher's exact test, as appropriate...
August 30, 2016: International Journal of Infectious Diseases: IJID
Andrew J Hale, Mary LaSalvia, James E Kirby, Allison Kimball, Rachel Baden
Asplenic patients are at increased risk for sepsis and fulminant infection. Sepsis in these patients is typically secondary to encapsulated bacteria, with Streptococcus pneumoniae being the most frequent pathogen. Rare complications of severe sepsis include purpura fulminans and bilateral adrenal hemorrhage (Waterhouse-Friderichsen syndrome). We present the case of a 36-year-old woman, healthy except for splenectomy years prior for idiopathic thrombocytopenic purpura treatment, who presented with fever. Upon presentation to our hospital, three hours after symptoms onset, she had purpura fulminans and shock...
2016: IDCases
Yutaro Sasaki, Kazuyoshi Izumi, Yasuo Kawanishi
In this report, we describe two cases of overwhelming post-splenectomy infection (OPSI). The first case was in a 70-year-old man who received a splenectomy in 2012 due to pancytopenia induced by hepatic cirrhosis. He presented with fever and fatigue. A blood test and abdominal ultrasonography were performed. However, these examinations did not indicate any abnormal findings. He unexpectedly suffered from septic shock and acute renal failure the following day. Treatment consisted of mechanical ventilation, broad-spectrum antibiotics and continuous hemodiafiltration...
May 2016: Hinyokika Kiyo. Acta Urologica Japonica
Ruta Arays, Sahil Goyal, Kim M Jordan
Common variable immunodeficiency (CVID) is readily considered in patients presenting with recurrent sino-pulmonary infections, however this disease has a broad range of clinical manifestations and diagnosis can be delayed by several years. We present the case of a 44-year-old postpartum female who presented with nausea, vomiting and abdominal distension. Four years prior, she was hospitalized for treatment of immune thrombocytopenia (ITP) with splenectomy and rituximab followed by two episodes of bacterial meningitis despite immunizations...
August 2016: Postgraduate Medicine
Kosuke Hirose, Hirohisa Okabe, Tomoharu Yoshizumi, Hideaki Uchiyama, Toru Ikegami, Norifumi Harimoto, Shinji Itoh, Koichi Kimura, Hideo Baba, Yoshihiko Maehara
A 62-year-old woman was admitted for acute epigastralgia and high-grade fever of over 39 °C. The patient had undergone splenectomy for idiopathic portal hypertension 1 year ago and vaccination against Streptococcus pneumoniae immediately post operation. She developed localized peritoneal irritation and abdominal distension. Her serum creatinine had increased to 1.5 mg/dL and procalcitonin was 12.5 ng/ml. Computed tomography of the abdomen revealed edematous large intestine and increased ascites. From these results, the patient was considered to have spontaneous bacterial peritonitis (SBP)...
December 2016: Surgical Case Reports
Ikramullah Khan Akhtar, Muhammad Ashraf, Irum Uzma Khalid, Mukhtar Hussain
OBJECTIVE: To determine the surgical outcome of splenectomy in children with thalassemia major. METHODS: It is an observational and descriptive study conducted in Department of Paediatric Surgery in collaboration with hematology, radiology, anesthesia and paediatric intensive care department at The Children's Hospital and the Institute of Child Health, Multan during the period of September 2007 to September 2013. A total of 50 patients suffering from thalassemia major already diagnosed and under management reffered from haematology department for splenectomy were included in this study...
March 2016: Pakistan Journal of Medical Sciences Quarterly
Anne Katrine Blaabjerg, Anna Holst Schumacher, Bjørn Kantsø, Lena Hagelskjær Kristensen, Helga Schumacher
This is the first case report of recurrent invasive pneumococcal disease (IPD), specifically, due to serotype 12F. The patient described here was vaccinated with the 23-valent pneumococcal polysaccharide vaccine (PPV23) due to previous splenectomy, and an anti-pneumococcal IgG test concluded that she had responded sufficiently to vaccination. Still, she had a fulminate recurrent infection with PPV23 serotype 12F. We investigated the anti-pneumococcal IgG test, and it turned out that it is based on the geometric mean value of only 12 of the serotypes included in PPV23; 12F is none of them...
March 2016: European Journal of Microbiology & Immunology
Rhonda J Hammerquist, Kimberly A Messerschmidt, April A Pottebaum, Thaddaus R Hellwig
PURPOSE: The recommended immunizations for adult asplenic patients are reviewed. SUMMARY: Patients without a spleen are at risk of developing overwhelming postsplenectomy infections due to encapsulated organisms, mainly pneumococcal, meningococcal, and Haemophilus influenzae type b (Hib). Due to the high mortality rates associated with these infections, vaccinations are recommended as a preventive measure. It is challenging to ensure optimal immunizations in these high-risk patients due to the number of recommended vaccines, the availability of multiple formulations, and the inability to administer specific formulations at the same time, as well as differences in subsequent vaccine administration schedules...
May 1, 2016: American Journal of Health-system Pharmacy: AJHP
Alejandrina Vendrell, Claudia Mongini, María José Gravisaco, Andrea Canellada, Agustina Inés Tesone, Juan Carlos Goin, Claudia Inés Waldner
Primary tumor excision is one of the most widely used therapies of cancer. However, the risk of metastases development still exists following tumor resection. The liver is a common site of metastatic disease for numerous cancers. Breast cancer is one of the most frequent sources of metastases to the liver. The aim of this work was to evaluate the efficacy of the orally administered Salmonella Typhi vaccine strain CVD 915 on the development of liver metastases in a mouse model of breast cancer. To this end, one group of BALB/c mice was orogastrically immunized with CVD 915, while another received PBS as a control...
2016: Frontiers in Immunology
Carmen Martino, Maria Serena Gallone, Michele Quarto, Cinzia Germinario, Silvio Tafuri
Patients with anatomic or functional asplenia have a 10-50 times higher risk than general population to develop Overwhelming Post-Splenectomy Infection. Evidences are unanimous in recommending splenectomised patients to receive meningococcal, antipneumococcal and Haemophilus influenzae type B vaccinations according to a specific timing. In Italy there are no current data on the immunisation coverage in these patients. This study aims to investigate immunisation coverage in patients undergoing elective or urgent splenectomy for 2012-2013 in the 3 Apulian hospitals...
May 3, 2016: Human Vaccines & Immunotherapeutics
J A G Schimmer, A F W van der Steeg, W P Zuidema
PURPOSE: Splenic artery embolization (SAE), proximal or distal, is becoming the standard of care for traumatic splenic injury. Theoretically the immunological function of the spleen may be preserved, but this has not yet been proven. A parameter for measuring the remaining splenic function must therefore be determined in order to decide whether or not vaccinations and/or antibiotic prophylaxis are necessary to prevent an overwhelming post-splenectomy infection (OPSI). METHODS: A systematic review of the literature was performed July 2015 by searching the Embase and Medline databases...
March 2016: Injury
M A Elfeki, R Paz-Fumagalli, A M Tiemeier, S Pungpapong, D M Sella, G T Frey, K R Musto, J H Nguyen, D M Harnois
BACKGROUND: Complications of cirrhosis may persist after liver transplantation. When indicated, partial splenic embolization (PSE) is an alternative to splenectomy but can cause severe infection. The identification of modifiable risk factors when performing PSE in immunocompromised liver transplant recipients may help reduce the risk of severe infection. METHODS: Data were collected retrospectively for all PSE performed after liver transplantation at a single institution and included demographics, etiology of liver disease, indication for PSE, vaccination status, laboratory findings, procedural details, extent and pattern of splenic infarction, hospital length-of-stay, readmissions, procedural complications, and mortality...
December 2015: Transplantation Proceedings
Giuseppe Leone, Eligio Pizzigallo
Splenectomy, while often necessary in otherwise healthy patients after major trauma, finds its primary indication for patients with underlying malignant or nonmalignant hematologic diseases. Indications of splenectomy for hematologic diseases have been reducing in the last few years, due to improved diagnostic and therapeutic tools. In high-income countries, there is a clear decrease over calendar time in the incidence of all indication splenectomy except nonmalignant hematologic diseases. However, splenectomy, even if with different modalities including laparoscopic splenectomy and partial splenectomy, continue to be a current surgical practice both in nonmalignant hematologic diseases, such as Immune Thrombocytopenic Purpura (ITP), Autoimmune Hemolytic Anemia (AIHA), Congenital Hemolytic Anemia such as Spherocytosis, Sickle Cell Anemia and Thalassemia and Malignant Hematological Disease, such as lymphoma...
2015: Mediterranean Journal of Hematology and Infectious Diseases
Thomas A Mitchell, Timothy E Wallum, Christopher E White, Kelly E Sanders, James K Aden, Jeffrey A Bailey, Lorne H Blackbourne, Clinton K Murray
OBJECTIVES: Postsplenectomy vaccination (PSV) in an austere environment to minimize overwhelming postsplenectomy infection is challenging. We evaluated the clinical impact of a March 2008 clinical practice guideline (CPG) dictating immediate PSV at North American Treaty Organization Role 3 medical treatment facilities and subsequent complications. METHODS: Utilizing U.S. military medical databases, we characterized all U.S. patients with a splenic injury from November 2002 to January 2012 by their surgical management: laparotomy with splenectomy (LWS), laparotomy without splenectomy, or nonoperative management...
November 2015: Military Medicine
Gerald P Kealey, Vinayak Dhungel, Matthew J Wideroff, Junlin Liao, Kent Choi, Dionne A Skeete, Michele A Lilienthal, Janelle Born, Graeme Pitcher
BACKGROUND: The purpose of this study was to determine the rates of initial vaccinations after splenectomy for trauma, assess the effectiveness of patient education on reimmunizations, and evaluate patients' utilization of their knowledge regarding immunization after discharge. METHODS: From June 1996-December 2011, 144 patients underwent splenectomy after traumatic injury. A telephone survey was completed in 100 of 144 splenectomized patients (69%) at a mean of 7...
December 2015: Journal of Surgical Research
Ella J Ariza-Heredia, Roy F Chemaly
Compared with the general population, patients with cancer in general are more susceptible to vaccine-preventable infections, either by an increased risk due to the malignancy itself or immunosuppressive treatment. The goal of immunizations in these patients is therefore to provide protection against these infections, and to decrease the number of vulnerable patients who can disseminate these organisms. The proper timing of immunization with cancer treatment is key to achieving better vaccine protection. As the oncology field continues to advance, leading to better quality of life and longer survival, immunization and other aspects of preventive medicine ought to move to the frontline in the care of these patients...
2015: Human Vaccines & Immunotherapeutics
Renato Costi, Carolina Castro Ruiz, Alban Zarzavadjian le Bian, Daniele Scerrati, Caterina Santi, Vincenzo Violi
BACKGROUND: Splenic hydatidosis is a rare condition and is usually managed by total splenectomy, which is associated to various complications, including overwhelming post-splenectomy sepsis and thrombosis. Probably due to supposed technical difficulties, the partial splenectomy is rarely performed being often unknown to physicians, infectious disease specialists and surgeons. METHODS: Demographic, clinical and surgical data were collected of four consecutive patients undergoing partial (or hemi-) splenectomy using an original, recently improved technique as a treatment for polar splenic hydatid cyst...
August 2015: International Journal of Surgery
Abdolreza Sotoodeh Jahromi, Karamatollah Rahmanian, Mohammad Hasan Davami, Hassan Zabetian, Alireza Yousefi, Abdolhossien Madani
Patients with beta-thalassaemia major and asplenia have an increased risk of encapsulated bacterial infections. The aim of this study was to determine the Haemophilus influenza type b (Hib) antibody concentrations in beta-thalassaemia patients with or without spleens. The Hib antibody concentrations were investigated in 850 patients with thalassaemia major, of whom 437 had undergone splenectomy. Hib antibody levels equal or greater than 1.0 μg mL(-1) were classified as long-term protection, those between 0...
November 2014: Pakistan Journal of Biological Sciences: PJBS
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