Overwhelming postsplenectomy infection (opsi) in a patient who had undergone gastrectomy—report of a case

A 76-year-old woman who had undergone splenectomy combined with total gastrectomy for advanced gastric cancer was admitted to our hospital because of high fever, dehydration and mental confusion 10 months after surgery. The patient began receiving antibiotics, intravenous immunoglobulin, and thrombo...

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Published inNihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 73; no. 7; pp. 1629 - 1633
Main Authors KITAMI, Chie, KAWACHI, Yasuyuki, NISHIMURA, Atsushi, MAKINO, Shigeto, KAWAHARA, Mikako, NIKUNI, Keiya
Format Journal Article
LanguageJapanese
Published Japan Surgical Association 2012
Subjects
gastric cancer
overwhelming postsplenectomy infection (OPSI)
Streptococcus pneumonia
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Summary:A 76-year-old woman who had undergone splenectomy combined with total gastrectomy for advanced gastric cancer was admitted to our hospital because of high fever, dehydration and mental confusion 10 months after surgery. The patient began receiving antibiotics, intravenous immunoglobulin, and thrombomojulin for disseminated intravascular coagulation. The result of blood culture revealed sepsis due to Streptococcus pneumonia, which we diagnosed as OPSI. Splenectomized patients have been recognized as immunocompromized hosts, for whom fulminant bacterial infection can be associated with high morbidity and mortality. Therefore, early diagnosis and urgent treatments are important to reduce the mortality of such infections. To prevent OPSI, adequate vaccination and prophylactic administration of antibiotics seem to be effective. Physicians should always be aware of the onset of OPSI for splenectomized patients.
ISSN:1345-2843
1882-5133
DOI:10.3919/jjsa.73.1629