Hazard of Severe Infections in Splenectomized Infants and Children

[摘要] A series of 19 cases of severe infection, often fulminating and in 6 terminating fatally, following splenectomy is presented. In all but two cases the spleen had been removed because of a blood disorder. The pneumococcus was the most frequent infecting organism. Meningitis was the commonest type of infection and the remainder were in several well-defined categories: Acute pericarditis, acute endocarditis, and septicemia. The infections occurred from 1 day to 16 years after splenectomy. The ages of the patients at the time of splenectomy range from 13 months to 17 years. Possible explanations for a lowered resistance to infection in splenectomized patients are discussed. The experience of the authors appears to justify their conclusion that children who have had the spleen removed require alert supervision for the appearance of threatening infections in order that prompt and adequate treatment may be administered. The problem of prophylatic treatment is discussed. Some previous reports of similar experience of severe infections occurring in splenectomized patients are summarized but no estimate of the actual incidence of this phenomenon amongst splenectomized children is available. It is suggested that this is more than a random association.

[学科分类] 儿科学