Prevention of infection in haematological patients after splenectomy and those suffering from hypersplenism: recommendations of the CzEch Leukemia Study Group for Life (CELL

Czech version

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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Article was published in

Transfusion and Haematology Today

2018 Issue 4