—In their excellent article on sepsis following splenectomy for trauma, Zarrabi and Rosner1 concluded that patients who were splenectomized for trauma are in risk of sepsis, and that they should receive penicillin prophylaxis and pneumococcal vaccine. However, I think that although both means are to be encouraged, we cannot rely on them to afford complete protection, because both have failed to avoid sepsis.2 On the other hand, both naturally occurring splenosis, and omental implantation of free grafts of splenic tissue, can restore some, but not all, of the immunologic deficits that follows splenectomy.3 In the article by Zarrabi and Rosner, we can find no more than four cases of sepsis with splenosis or ectopic splenic tissue. Indeed, the rarity of overwhelming postsplenectomy sepsis after splenectomy for trauma (a rather frequent operation) is generally attributed to splenosis.4
Although incomplete, the protection given by splenosis and/or splenic
Gonzaga RAF. To the Editor. Arch Intern Med. 1985;145(2):370. doi:10.1001/archinte.1985.00360020214048
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