To the Editor.
—It is surprising that in their study of risk factors for acquiring pneumococcal infections, Lipsky et al1 fail to mention splenectomy as a risk factor. Postsplenectomy pneumococcal pneumonia, meningitis, and/or sepsis in children is a well-recognized hazard. Adults with Hodgkin's disease are also at risk of developing serious pneumococcal infections months or years after staging laparotomy and splenectomy.2 Splenectomy for trauma in adults also puts patients at risk.3 It is recommended that all patients undergoing splenectomy be immunized with pneumococcal vaccine (preferably before the splenectomy) and receive penicillin prophylactically for at least two years following the splenectomy.
Rosner F, Zarrabi MH. Risk Factors for Acquiring Pneumococcal Infections. Arch Intern Med. 1987;147(2):212. doi:10.1001/archinte.1987.00370020032025