Prevention and treatment of infection in patients with an absent or hypofunctional spleen: A British Society for Haematology guideline.
Author
Ladhani, Shamez NFernandes, Savio
Garg, Mamta
Borrow, Ray
de Lusignan, Simon
Bolton-Maggs, Paula HB
Affiliation
St. George's University of London; UK Health Security Agency Colindale; The Dudley Group Foundation NHS Trust et alPublication date
2024-04-10Subject
Gastroenterology
Metadata
Show full item recordAbstract
Guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen were published by the British Committee for Standards in Haematology in 1996 and updated in 2002 and 2011. With advances in vaccinations and changes in patterns of infection, the guidelines required updating. Key aspects included in this guideline are the identification of patients at risk of infection, patient education and information and immunisation schedules. This guideline does not address the non-infective complications of splenectomy or functional hyposplenism (FH). This replaces previous guidelines and significantly revises the recommendations related to immunisation. Patients at risk include those who have undergone surgical removal of the spleen, including partial splenectomy and splenic embolisation, and those with medical conditions that predispose to FH. Immunisations should include those against Streptococcus pneumoniae (pneumococcus), Neisseria meningitidis (meningococcus) and influenza. Haemophilus influenzae type b (Hib) is part of the infant immunisation schedule and is no longer required for older hyposplenic patients. Treatment of suspected or proven infections should be based on local protocols and consider relevant anti-microbial resistance patterns. The education of patients and their medical practitioners is essential, particularly in relation to the risk of serious infection and its prevention. Further research is required to establish the effectiveness of vaccinations in hyposplenic patients; infective episodes should be regularly audited. There is no single group ideally placed to conduct audits into complications arising from hyposplenism, highlighting a need for a national registry, as has proved very successful in Australia or alternatively, the establishment of appropriate multidisciplinary networks. � 2024 British Society for Haematology and John Wiley & Sons Ltd.Citation
Ladhani SN, Fernandes S, Garg M, Borrow R, de Lusignan S, Bolton-Maggs PHB; BSH Guidelines Committee. Prevention and treatment of infection in patients with an absent or hypofunctional spleen: A British Society for Haematology guideline. Br J Haematol. 2024 May;204(5):1672-1686. doi: 10.1111/bjh.19361. Epub 2024 Apr 10. PMID: 38600782.PMID
38600782Publisher
Wiley-Blackwellae974a485f413a2113503eed53cd6c53
10.1111/bjh.19361