Abstract
A risk of fatal infection complications regarding patients after splenectomy - can we avoid it? The OPSI (Overwhelming Post-splenectomy Infection) is a syndrome occurring in patients treated by splenectomy, for either a trauma, haematological, or another indication. These patients are at high-risk of a sepsis development even during minimal infection insult; the risk of sepsis is five to six times higher than in normal population.
On average, 20 patients after acute splenectomy are treated at the Department of Anaesthesiology, Resuscitation and Intensive Care of the University Hospital Pilsen; mainly as a part of a polytrauma. The authors describe a case of fatal OPSI in a patient with a history of splenectomy circa eighteen years back.
In this case the procedures suggested for a post-splenectomy patients has not been performed (i.e. after-splenectomy vaccination, observation at an infection unit, emergency package of ATB, a splenectomy card). The said patient suffered invasive pneumococcus sepsis, which has been clinically manifested with a fulminant ontset, hemocoagulation disorder and circulation instability.
Despite the timely and adequate treatment, including the antibiotic, the patient died 36 hours after the first symptoms occurrence. The authors further describe that the OPSI syndrome can be avoided by following the generally valid guidelines; however, these guidelines are not commonly followed in practice.
The authors also suggest a solution on how to improve current situation by a intensivist-oncologist-general practitioner cooperation.