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February 15, 1980

Infection After Splenectomy

JAMA. 1980;243(7):652. doi:10.1001/jama.1980.03300330016018

To the Editor.—  In the QUESTIONS AND ANSWERS section of The Journal, Theodore H. Spaet, MD (242:1413, 1979), concluded that long-term complications of splenectomy after trauma in adults were negligible. Although reference was made to the increased susceptibility to infection in asplenic patients, the author limited the risk to young children and "perhaps adolescents."In November 1977, Gopal and Bisno1 reported the cases of five asplenic persons without underlying disease in whom fulminant pneumococcemia developed. Three of the five patients were 15, 20, and 27 years of age, and all three patients died. Gopal and Bisno also presented an extensive literature review and summarized 20 other cases of overwhelming pneumococcemia in a "normal" asplenic host. Fourteen of the patients were 18 years or older, with an age range of from 7 to 71 years. Gopal and Bisno emphasized that the syndrome of fulminant pneumococcemia is abrupt in onset, with