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Hyposplenism and asplenia

What's new

Added 2024 BSH, 2017 WSES, and 2014 IDSA guidelines for the prevention and treatment of infection in patients with hyposplenism or asplenia.

Guidelines

Key sources

The following summarized guidelines for the management of hyposplenism and asplenia are prepared by our editorial team based on guidelines from the British Society for Haematology (BSH 2024), the Center for Disease Control (CDC 2020,2014), the European Society for the Study of Coeliac Disease (ESsCD 2019), the Infectious Diseases Society of America (IDSA/ATS 2019), the Korean Society of Infectious Diseases...
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Medical management

Antibiotic prophylaxis: as per BSH 2024 guidelines, Initiate prophylactic antibiotics in all patients immediately after splenectomy and continue for 1-3 years (until the age of 5 years in children, for at least 2 complete years).
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  • Management of infection

Specific circumstances

Patients with celiac disease: as per ESsCD 2019 guidelines, Offer pneumococcal vaccination in patients with celiac disease known to be hyposplenic.
B

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  • Patients with pneumonia

  • Patients with animal bites

Patient education

General counseling
As per BSH 2024 guidelines:
Provide appropriate written and/or electronic information to patients and ensure they carry a card to alert healthcare professionals to the risk of overwhelming infection.
A
Counsel patients about the potential risks of overseas travel, particularly concerning malaria and unusual infections such as those associated with animal bites.
B

Preventative measures

Immunizations, general principles: as per BSH 2024 guidelines, Administer vaccines against pneumococcus and meningococcus, as well as annual influenza immunization in patients after splenectomy or with functional hyposplenism.
A
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More topics in this section

  • Immunizations (pneumococcal)

  • Immunizations (meningococcal)

  • Immunizations (H. influenzae B)

  • Immunizations (influenza and COVID-19)

Quality improvement

Documentation
As per BSH 2024 guidelines:
Ensure that patient records are clearly labeled to indicate their underlying increased risk of serious infection and document up-to-date vaccination and re-vaccination status, with particular emphasis on documenting vaccines administered in non-primary care settings.
A
Maintain and regularly update the register of at-risk patients at the local healthcare level.
B