Asplenia and hyposplenia

Background

• Spleen is an important part of the immune system, particularly for encapsulated organisms
• Increased risk for severe sepsis
• Particularly increased risk for infection with:
  • Streptococcus pneumoniae
  • Haemophilus influenzae
  • Neisseria meningitidis
  • Capnocytophaga
  • Bordatella holmesii
  • Babesia
  • Plasmodium falciparum

Management

• Cornerstone of management is prevention with vaccination
  • Refer to Immunization of people with asplenia and hyposplenia
• Patients may also benefit from prophylaxis with twice-daily penicillin, amoxicillin, or cephalexin, or once-daily azithromycin
• Patients should also have pill-in-pocket broad-spectrum antibiotics to be taken in case of fever, such as amoxicillin-clavulanic acid or a respiratory fluoroquinolone