Complications infectieuses des splénectomies

The spleen has a crucial role in innate and adaptative immunity, particularly in protecting against infections caused by encapsulated bacteria and erythrocytic parasites. Thus, a post-splenectomy asplenia, or any other hyposplenic state, leads to a high risk of severe infection, mostly due to Streptococcus pneumoniae, with the possibility of an extremely severe form called overwhelming post-splenectomy infection (OPSI). This risk justifies the need for specific preventives measures, an antibiotic prophylaxis for at least 2 years post-splenectomy, and vaccine prophylaxis against encapsulated bacteria such as S. pneumoniae, Neisseiria meningitidis, and Haemophilus influenzae B. The need for emergency antibiotic therapy in any case of fever in asplenic patients is supported by the severity of OPSI and the risk of fulminant evolution. Education has the major role in prevention.