{"id":365,"date":"2020-04-21T17:33:01","date_gmt":"2020-04-21T09:33:01","guid":{"rendered":"http:\/\/www.perthhaematology.com.au\/?page_id=365"},"modified":"2020-04-21T18:07:06","modified_gmt":"2020-04-21T10:07:06","slug":"splenectomy","status":"publish","type":"page","link":"https:\/\/www.perthhaematology.com.au\/index.php\/splenectomy\/","title":{"rendered":"Splenectomy"},"content":{"rendered":"\n<p><span class=\"has-inline-color has-vivid-cyan-blue-color\"><strong>The main risk following splenectomy is severe infection<\/strong><\/span><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>greatest risk for children<\/li><li>commonest infection is Stretococcus pneumoniae (Pneumococcal sepsis)<\/li><li>risk of death from severe infection in normal people (with spleen) is 1 in 30,000 per year. After splenectomy the risk is 8x for adults and 50x for children (Or of 100 people without a spleen  1-5 of them would develop severe infection over 10 years.<\/li><li>risk seems greatest in childhood and for 2 years after splenectomy, but lifelong continued risk.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"has-inline-color has-vivid-cyan-blue-color\">Reducing the Risk of Infection<\/span><\/h2>\n\n\n\n<h2 class=\"wp-block-heading\"><\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li><strong><span class=\"has-inline-color has-vivid-cyan-blue-color\">Vaccination<\/span><\/strong><\/li><\/ul>\n\n\n\n<p><strong>Initial Vaccination (2 weeks before splenectomy or &gt;14 days after) <\/strong><\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td><strong>Agent<\/strong><\/td><td><strong>Vaccine<\/strong><\/td><\/tr><tr><td>Pneumococcus <\/td><td>13 valent conjugate vaccine &#8211; 13vPCV (eg Prevenar 13) im<\/td><\/tr><tr><td>Meningococcus <br>B<\/td><td>Meningococcal B recombinant vaccine (MenBV) (eg Bexsero) im<\/td><\/tr><tr><td>Meningococcus ACWY<\/td><td>Meningococcal quadrivalent conjugate ACWY vaccine (4vMenCV)(eg Menactra, Menveo, Nimenrix) im<\/td><\/tr><tr><td>Haemophilus Influenza Type B<\/td><td>Conjugate HiB vaccine (HiB) (Eg Hiberix, Act-HiB) im<\/td><\/tr><tr><td>Influenza<\/td><td>Influenza vaccine &#8211; and annually pre-winter<\/td><\/tr><\/tbody><\/table><figcaption>Initial vaccination (2 weeks before splenectomy or &gt;14 days after)<\/figcaption><\/figure>\n\n\n\n<p><strong>8 weeks later<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td><strong>Agent<\/strong><\/td><td><strong>Vaccine<\/strong><\/td><td><strong>Booster<\/strong><\/td><\/tr><tr><td>Pneumococcus<\/td><td>23 valent pneumococcal polysaccharide vaccine (23vPPV) (eg Pneumovax 23) im\/sc<\/td><td>5 years<\/td><\/tr><tr><td>Meningococcus<\/td><td>Meningococcal quadrivalent ACWY vaccine (4vMenCV)<br>Meningococcal B recombinant vaccine (MenBV)<\/td><td>5 years for ACWY only <br>(no booster for B)<\/td><\/tr><tr><td>Haemophilus influenzae B<\/td><td>Nil<\/td><td>Nil<\/td><\/tr><\/tbody><\/table><figcaption>8 weeks later<\/figcaption><\/figure>\n\n\n\n<ul class=\"wp-block-list\"><li><span class=\"has-inline-color has-vivid-cyan-blue-color\"><strong>Regular (prophylactic) antibiotics:<\/strong><\/span><ul><li>Penicillinn V 250mg bd (125mf if &lt; 6 years old)<\/li><li>If penicillin allergy: erythromycin 250mg bd or roxithromycin 150mg\/day<\/li><li>? stop after age 16 or 2 years after splenectomy in adults (some continue lifelong)<\/li><\/ul><\/li><li><span class=\"has-inline-color has-vivid-cyan-blue-color\"><strong>Emergency antibiotic supply:<\/strong><\/span><ul><li>alternative to (or in addition to) prophylactic antibiotics<\/li><li>Home supply of: amoxycillin 3g; or erythromycin 1g qid; or roxithromycin 300mg &#8211; if fever occurs take 1 dose and seen medical advice<\/li><\/ul><\/li><li><span class=\"has-inline-color has-vivid-cyan-blue-color\"><strong>Caution with minor infections:<\/strong><\/span><ul><li>Advise to seek medical assistance at onset of infection<\/li><\/ul><\/li><li><span class=\"has-inline-color has-vivid-cyan-blue-color\"><strong>Precautions against malaria:<\/strong><\/span><ul><li>avoid mosquito bites in maaria areas(repellants, nets, DEET, long sleeves)<\/li><li>anti-malaria prophylaxis tablets<\/li><\/ul><\/li><li><span class=\"has-inline-color has-vivid-cyan-blue-color\"><strong>Education of family and Medic-Alert bracelet<\/strong><\/span><\/li><\/ul>\n\n\n\n<p><span class=\"has-inline-color has-luminous-vivid-orange-color\">Spleen Australia website has good information and a chart of vaccine with timeline.<\/span><\/p>\n\n\n\n<p class=\"has-text-align-right has-small-font-size\"><span class=\"has-inline-color has-very-dark-gray-color\">Updated March 2019<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The main risk following splenectomy is severe infection greatest risk for children commonest infection is Stretococcus pneumoniae (Pneumococcal sepsis) risk <\/p>\n<div class=\"read-more-text\"><a href=\"https:\/\/www.perthhaematology.com.au\/index.php\/splenectomy\/\" class=\"read-more\">continue reading<\/a><\/div>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-365","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.perthhaematology.com.au\/index.php\/wp-json\/wp\/v2\/pages\/365","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.perthhaematology.com.au\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.perthhaematology.com.au\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.perthhaematology.com.au\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.perthhaematology.com.au\/index.php\/wp-json\/wp\/v2\/comments?post=365"}],"version-history":[{"count":7,"href":"https:\/\/www.perthhaematology.com.au\/index.php\/wp-json\/wp\/v2\/pages\/365\/revisions"}],"predecessor-version":[{"id":381,"href":"https:\/\/www.perthhaematology.com.au\/index.php\/wp-json\/wp\/v2\/pages\/365\/revisions\/381"}],"wp:attachment":[{"href":"https:\/\/www.perthhaematology.com.au\/index.php\/wp-json\/wp\/v2\/media?parent=365"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}