Prevention of infection in haematological patients after splenectomy and those suffering from hypersplenism: recommendations of the CzEch Leukemia Study Group for Life (CELL
Authors:
T. Kabut 1; B. Weinbergerová 1; I. Kocmanová 2; P. Žák 3; A. Zavřelová 3; M. Kouba 4; L. Drgoňa 5; M. Navrátil 6; P. Múdrý 7; J. Štěrba 7; P. Sedláček 8; P. Keslová 8; J. Haber 9; N. Mallátová 10; D. Tanušková 11; J. Novák 12; E. Faber 13; J. Mayer 1; Z. Ráčil 1
Authors‘ workplace:
Interní hematologická a onkologická klinika, FN Brno a LF MU, Brno
1; Oddělení klinické mikrobiologie, FN Brno, Brno
2; IV. interní hematologická klinika, FN Hradec Králové, Hradec Králové
3; Ústav hematologie a krevní transfuze, Praha
4; Národní onkologický ústav, Bratislava
5; Klinika hematoonkologie, FN Ostrava, Ostrava
6; Klinika dětské onkologie, FN Brno, Brno
7; Klinika dětské hematologie a onkologie, FN v Motole, Praha
8; Klinika hematologie, Všeobecná fakultní nemocnice, Praha
9; Pracoviště parazitologie a mykologie, Nemocnice České Budějovice, a. s., České Budějovice
10; Transplantačná jednotka kostnej drene – Klinika detskej hematológie a onkológie, Detská fakultná nemocnica, s poliklinikou, Bratislava
11; Interní hematologická klinika, FN Královské Vinohrady, Praha
12
Published in:
Transfuze Hematol. dnes,24, 2018, No. 4, p. 304-313.
Category:
Overview
Asplenic patients are at significant risk of infectious complications. The most prevalent pathogens causing infections in this high-risk group include encapsulated bacteria, especially Streptococcus pneumonia. The most serious form of infection in asplenic patients is septic syndrome, commonly referred to as “overwhelming post-splenectomy infection”. All asplenic patients are at the risk of this infection characterised by a highly dramatic clinical course. However, patients splenectomised for haematological diseases are those at greatest risk in this group. Moreover, the risk of infection is increased by ongoing oncological treatment or immunosuppressive therapy. The risk of infection can be reduced by simple preventive measures: adequate patient education and emergency antibiotics, vaccination against selected pathogens according to current recommendations and antibiotic prophylaxis in indicated cases. Based on the updated international recommendations, especially in the field of vaccination, new recommendations of the CzEch Leukemia Study Group for Life (CELL) for the prevention of infectious complications in haematological patients after splenectomy have been drawn up and are presented in this paper.
Key words:
splenectomy – infectious prevention – overwhelming post-splenectomy infection – post-splenectomy septic syndrome – post-splenectomy education – post-splenectomy vaccination – post-splenectomy antibiotic prophylaxis
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Haematology Internal medicine Clinical oncologyArticle was published in
Transfusion and Haematology Today
2018 Issue 4
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