Talk:Overwhelming post-splenectomy infection

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I just removed the part that said that bacterias "evolved" into something, without changing the rest of the text or the related concepts — Preceding unsigned comment added by Tewfik5 (talk • contribs) 20:40, 15 July 2013 (UTC)[reply]

I[edit]

I do not think this should be a "stub" requiring expansion. The process is of a septicaemia and the cause is lack of functioning spleen (asplenia) both of which already covered. David Ruben 23:01, 12 Jun 2005 (UTC)

Hmm... If there really isn't anything else to be said about the infection, then it could be very well just merged into either sepsis (septicaemia redirects there), asplenia or both. My opinion is that it can be expanded — for example, what about the occuring rates (is it rare or more common); who get the disease, where, why and when; are there any specific symptoms; etc. I've no medical education though, perhaps someone knows a bit more about the subject?—Pt_(T) 08:59, 18 August 2005 (UTC)[reply]

Good points. There is still a risk of duplication between this, septicaemia and asplenia (oh and splenectomy), but the "occuring rates ..." is a valid point. Let me mull over this a few days and I will then relook at the relevant pages and see what I can do.David Ruben^talk 02:43, 22 August 2005 (UTC)[reply]

I added a little bit on the mechanism of infection. It's not complicated, but its enough to explain to medical school students and maybe the general public. (BF) 20:25, 27 April 2007 134.174.6.211 (talk · contribs)

sepsis following splenectomy is a separate category[edit]

In 2002, an infectious disease specialist (the late Dr. Leland Rickman, incoming president of the Infectious Disease Assn. of Californian) shared in personal communication with me that surgical asplenia is distinct because there is no re-generation of tissue as he had seen was the case with non-surgical asplenia. Further, immunizations in the asplenic patient do not/may not? provide the same immune system response as in other individuals. Did his observations ever make it into the medical literature? --MichelleInSanMarcos (talk) 16:52, 9 November 2017 (UTC)[reply]

This case study has not been published so cannot be included in the wikiepdia article; nevertheless it supports the idea that OPSI is its own category[edit]

In November 1999, in a patient with sepsis 18 years post-surgery, it was the case that the illness went unrecognized at an emergency room attached to a teaching university until the patient's relative--who had medical training--insisted that a spinal be done, which was positive for bacteria-resistant pneumococcal meningitis. It happened that a proximal relative with non-surgical asplenia that was unrelated to sickle cell anemia complications (ie, the relative's asplenia was due to trauma) did not contract the illness although in close quarters throughout. Following three weeks of Vancomycin, the patient recovered. The patient had received the then-requisite pneumococcal vaccine post-splenectomy, following the protocol used at the time of surgery, but titres subsequent to recovery showed an uneven profile of antibodies for the strains in the serum, except for a spike at #24.--MichelleInSanMarcos (talk) 16:52, 9 November 2017 (UTC)[reply]

The article references preventative measures - immunization, antibiotics -- but not the need for patient education[edit]

Patient awareness of imunno-compromise status is critical. Information on the Internet for asplenic patients: a systematic review - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3191896/ The article starts with the assertion, "Asplenic patients in general have poor knowledge about their condition." The article points out that OPSI prevention requires patient education. "Asplenic patients are an often overlooked group of immunocompromised patients who are at risk for serious infections." MichelleInSanMarcos (talk) 05:26, 8 March 2018 (UTC)[reply]

See also https://www.uptodate.com/contents/preventing-severe-infection-after-splenectomy-beyond-the-basics Patient education: Preventing severe infection after splenectomy (Beyond the Basics) - Fever greater than 100.4ºF or 38ºC MichelleInSanMarcos (talk) 05:32, 8 March 2018 (UTC)[reply]

Proposed section: various health systems differ in choice of prevention[edit]

Listing by country sheds light on the different incidence and outcomes, as well. I haven't seen a primary source that does this. MichelleInSanMarcos (talk) 23:08, 3 April 2019 (UTC)[reply]

What is "rare"?[edit]

The first sentence includes the word "rare," referencing a paper, which in turn references a 1996 paper that includes "an estimated lifetime risk for OPSI of approximately 5%." I hesitate to include this incidence because it is from 1996; on the other hand, perhaps the rate has remained stable. Waghorn DJ (March 2001). "Overwhelming infection in asplenic patients: current best practice preventive measures are not being followed". Journal of Clinical Pathology. 54 (3): 214–8. doi:10.1136/jcp.54.3.214. PMC 1731383. PMID 11253134. Rather than use a qualitative word, why not hit the rate itself? Is "rare" a technical term that means 1 standard deviation from the norm? MichelleInSanMarcos (talk) 02:30, 2 August 2019 (UTC)[reply]