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November 12, 1982

Infection After Splenectomy

JAMA. 1982;248(18):2316. doi:10.1001/jama.1982.03330180076043

Postsplenectomy infection has engaged the attention of physicians at least since 1919.1 Publications on the role of the spleen or the sequelae of its absence continue to appear almost weekly. After decades of interest, what do we know about the risk of infection after splenectomy? We seem to know that young children experience a high attack rate, particularly of fulminant infections caused by encapsulated organisms. We have suspected the same thing about adults, although the evidence for this conclusion has been much less secure.

There has been general but not universal agreement that adults have a higher-than-normal risk of infection after splenectomy, and also that the magnitude of this risk varies with the reason for splenectomy. However, the measured or inferred risk estimates cover a very wide range.2-4 Schwartz and colleagues have provided several useful observations in their article, which appears in this issue (p 2279). The risk