A Case of Pneumococcal Endocarditis Complicating Overwhelming Postsplenectomy Infection

Abstract

Postsplenectomy patients are susceptible to severe infections due to encapsulated bacteria such as Streptococcus pneumoniae and Haemophilus influenzae and this condition is widely known as Overwhelming Postsplenectomy Infection (OPSI). OPSI is relatively rare in conditions with rapid progression and high mortality rates. There are very few reports of infective endocarditis from OPSI. A 40-year-old man who underwent splenectomy 20 years before was transported to the emergency room. He had severe heart failure and multiple cerebral embolisms. The echocardiography showed vegetation on the aortic valve and severe regurgitation due to perforation of the non-coronary cusp. We performed aortic valve replacement on an emergent basis. In infected patients after splenectomy, early diagnosis and prompt treatment are desired because of the possibility of rapid progression of sepsis in encapsulated bacteria and poor prognosis.