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JAMA Patient Page
November 23/30, 2005

The Spleen

JAMA. 2005;294(20):2660. doi:10.1001/jama.294.20.2660

The spleen is an organ that lies behind the stomach on the left side of the abdomen. It serves as a graveyard for old or flawed red blood cells (oxygen-carrying cells) and as a storage site for blood and platelets (essential for clotting). The spleen also clears bacteria and is important for proper immune function, especially in fighting bacteria. Diseases associated with impaired spleen function include sickle cell anemia (a disease that causes irregularly shaped red blood cells) and malaria (a parasite infection of the blood). Some people may need removal of the spleen to prevent deadly bleeding that can occur after an injury, to treat diseases that cause disruption of blood cells), or to treat cancers involving the spleen.

The November 23/30, 2005, issue of JAMA includes an article about children who sustain an injury to the spleen.

REMOVAL OF THE SPLEEN

If part of the spleen is removed, the spleen may regenerate. If a patient undergoes a total splenectomy (removal of the entire spleen), it will not regenerate, but many functions of the spleen are taken over by other organs. However, absence of a functioning spleen increases the risk of bacterial infection. These infections can be serious and life-threatening. Those at greatest risk are young children who lose their spleen and other persons of any age during the first 2 years after splenectomy.

VACCINES

Persons who do not have a functioning spleen or have undergone a splenectomy should be given a pneumococcal polysaccharide vaccine (a vaccine that prevents a bacterial infection of the lungs and other organs), a meningococcal polysaccharide vaccine (a vaccine that prevents a bacterial infection of the brain lining and other organs), and a Haemophilus influenzaetype b vaccine (a vaccine that prevents a bacterial infection of the brain lining, ear, and other organs). After a splenectomy, discuss with your doctor when you should be vaccinated. Also, keep a record of when you received these and other vaccines.

ANTIBIOTICS

Antibiotics (medications that fight bacteria) are needed daily to help prevent bacterial infections in infants and children without a functioning spleen. Adults usually do not need daily antibiotics. However, if someone without a functioning spleen develops a fever, antibiotics may be needed. In addition, persons without a functioning spleen are susceptible to certain serious infections from dog bites or scratches and deer tick bites. Seek medical care if you develop a fever or other illness and have impaired spleen function or have undergone splenectomy. Discuss with your doctor the need for antibiotic prescriptions for home and for travel. Also, you should wear a medical alert bracelet stating you do not have a spleen.

FOR MORE INFORMATION

INFORM YOURSELF

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish.

Source: Centers for Disease Control and Prevention

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 718/946-7424.

TOPIC: ORGANS

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