Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
Online ISSN : 1882-5133
Print ISSN : 1345-2843
ISSN-L : 1345-2843
Case Reports
Overwhelming postsplenectomy infection (opsi) in a patient who had undergone gastrectomy—report of a case—
Chie KITAMIYasuyuki KAWACHIAtsushi NISHIMURAShigeto MAKINOMikako KAWAHARAKeiya NIKUNI
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2012 Volume 73 Issue 7 Pages 1629-1633

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Abstract
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.
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© 2012 Japan Surgical Association
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