the patient who has had a splenectomy

see also:

• pneumococcus

• patients who have had a splenectomy are at high risk of sepsis / septicaemia, in particular, due to pneumococcus
• in addition, risk applies to those patients with “functional asplenia” such as those with sickle cell disease (SCD)
• risk is highest in children and the immunocompromised, and the risk remains lifelong.

• standard schedule immunisation
• pneumococcal vaccination
• meningococcal vaccination
• annual influenza vaccination

• asplenic children < 5 years of age
• children < 5 years of age with sickle cell disease (SCD)
• for at least 3 years following splenectomy
• asplenic patients with severe underlying immunosuppression
• for at least 6 months after an episode of severe sepsis in asplenic patients

• amoxycillin 250mg (20 mg/kg for those under age 2yrs) once daily
• if penicillin allergy, then consider roxithromycin 150mg (4mg/kg in children to max 150mg), once daily