Asplenia primary prevention: Difference between revisions
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**All [[age-appropriate]] [[vaccines]] and the yearly [[influenzae]] [[vaccine]] should be given to [[household]] contacts of [[asplenic patients]]. | **All [[age-appropriate]] [[vaccines]] and the yearly [[influenzae]] [[vaccine]] should be given to [[household]] contacts of [[asplenic patients]]. | ||
**Before [[splenectomy]] and after the [[surgical removal]], [[vaccinations]] are also recommended.<ref name="pmid26130882">{{cite journal| author=Huebner ML, Milota KA| title=Asplenia and fever. | journal=Proc (Bayl Univ Med Cent) | year= 2015 | volume= 28 | issue= 3 | pages= 340-1 | pmid=26130882 | doi=10.1080/08998280.2015.11929267 | pmc=4462215 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26130882 }} </ref> | **Before [[splenectomy]] and after the [[surgical removal]], [[vaccinations]] are also recommended.<ref name="pmid26130882">{{cite journal| author=Huebner ML, Milota KA| title=Asplenia and fever. | journal=Proc (Bayl Univ Med Cent) | year= 2015 | volume= 28 | issue= 3 | pages= 340-1 | pmid=26130882 | doi=10.1080/08998280.2015.11929267 | pmc=4462215 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26130882 }} </ref> | ||
**[[Patient]] with [[functional asplenia]] or [[autosplenectomy]], it is also advised to continue [[aggressive]] [[vaccination]] [[schedules]]. Recommended vaccinations in these patients are the [[pneumococcal conjugate vaccine]] (PCV-13) 8 weeks in advance, as well as the [[pneumococcal polysaccharide vaccine]] (PPSV-23), [[Haemophilus influenzae type B]] vaccine (Hib), and the [[quadrivalent]] [[meningococcal conjugate]] [[vaccine]] before [[14 days]] of [[planned surgery]] for [[splenectomy]]. | **[[Patient]] with [[functional asplenia]] or [[autosplenectomy]], it is also advised to continue [[aggressive]] [[vaccination]] [[schedules]]. Recommended vaccinations in these patients are the [[pneumococcal conjugate vaccine]] (PCV-13) 8 weeks in advance, as well as the [[pneumococcal polysaccharide vaccine]] (PPSV-23), [[Haemophilus influenzae type B]] vaccine (Hib), and the [[quadrivalent]] [[meningococcal conjugate]] [[vaccine]] before [[14 days]] of [[planned surgery]] for [[splenectomy]]. | ||
*'''Revaccination''': In [[asplenia]] or [[splenic dysfunction]] patients [[antibody levels]] are likely to decline rapidly therefore [[revaccination]] with 23-valent PPV is recommended [[every five years]]. There is no required for testing of antibodies prior to vaccination. | |||
==Antibiotic prophylaxis== | ==Antibiotic prophylaxis== | ||
Revision as of 10:54, 20 July 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anum Dilip, M.B.B.S[2]
Overview
There are no established measures for the primary prevention of [disease name].
OR
There are no available vaccines against [disease name].
OR
Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
OR
[Vaccine name] vaccine is recommended for [patient population] to prevent [disease name]. Other primary prevention strategies include [strategy 1], [strategy 2], and [strategy 3].
Primary Prevention
Vaccination
- Up to 87% of asplenic patients were found to have been infected with Streptococcus pneumoniae, one of the most common bacterial pathogen leading to infection in patients with asplenia.[1]
- All patients with asplenia should receive the standard childhood and adolescent immunizations at the recommended age.[2]
- Immunizations against Streptococcus pneumoniae, Haemophilus influenzae type b (Hib), and Neisseria meningitidis should be ensured and may be administered on an earlier schedule than is routine, due to the risk of fulminant sepsis from encapsulated bacteria.
- Pneumococcal vaccine: Both the conjugated 13-valent pneumococcal vaccine and the 23-valent polysaccharide vaccine is recommended for the asplenic patient.
- Meningococcal vaccine: The conjugate quadrivalent meningococcal vaccine (MCV4) should be given.
- Haemophilus influenzae type b (Hib): Children with asplenia should receive the Hib vaccine, who present with a life-threatening Hib infection because the infection itself does not confer lifelong protection.
- Influenza vaccine: is recommended yearly, starting at six months of age, to lower the risk of secondary bacterial infections.
- All asplenic patients may be at risk of Salmonella infection while travelling to less developed areas of the world and should be immunized for Salmonella typhi.
- All age-appropriate vaccines and the yearly influenzae vaccine should be given to household contacts of asplenic patients.
- Before splenectomy and after the surgical removal, vaccinations are also recommended.[3]
- Patient with functional asplenia or autosplenectomy, it is also advised to continue aggressive vaccination schedules. Recommended vaccinations in these patients are the pneumococcal conjugate vaccine (PCV-13) 8 weeks in advance, as well as the pneumococcal polysaccharide vaccine (PPSV-23), Haemophilus influenzae type B vaccine (Hib), and the quadrivalent meningococcal conjugate vaccine before 14 days of planned surgery for splenectomy.
- Revaccination: In asplenia or splenic dysfunction patients antibody levels are likely to decline rapidly therefore revaccination with 23-valent PPV is recommended every five years. There is no required for testing of antibodies prior to vaccination.
Antibiotic prophylaxis
- For children
References
- ↑ Waghorn DJ (2001). "Overwhelming infection in asplenic patients: current best practice preventive measures are not being followed". J Clin Pathol. 54 (3): 214–8. doi:10.1136/jcp.54.3.214. PMC 1731383. PMID 11253134.
- ↑ Salvadori MI, Price VE, Canadian Paediatric Society, Infectious Diseases and Immunization Committee (2014). "Preventing and treating infections in children with asplenia or hyposplenia". Paediatr Child Health. 19 (5): 271–8. PMC 4029242. PMID 24855431.
- ↑ Huebner ML, Milota KA (2015). "Asplenia and fever". Proc (Bayl Univ Med Cent). 28 (3): 340–1. doi:10.1080/08998280.2015.11929267. PMC 4462215. PMID 26130882.