Management of fever in splenectomized adults: case report and theoretical reminder

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Halil Yildiz, Lucie Wartique, Jean-Cyr Yombi Published in the journal : September 2017 Category : Internal Medicine

Summary :

In asplenic patients, fever should never be trivialized. The clinical presentation of a severe infection can be unspecific (fever, chills, sore throat, diarrhea, vomiting, and muscle aches). If an antibiotherapy is not given rapidly, the evolution can be abrupt, and patients can develop a disseminated intravascular coagulation. We here describe the case of a 77-year-old splenectomized female patient. Given the unspecific clinical presentation, the diagnosis of acute gastro-enteritis was made; however, the patient developed a severe pneumococcal infection. With this case report, we would like to remind the adequate management of fever in asplenic patients in order to avoid severe, potentially life-threatening, complications

Key Words

Fever, splenectomy, antibiotherapy, vaccination, education

What is already known about the topic?

In all asplenic patients, fever can be the first sign of a severe infection, with a fatal evolution in 50% of cases. The most frequently responsible bacteria are S. pneumoniae, Haemophilus influenzae type b, Neisseria meningitidis, Escherichia coli, and Staphylococcus aureus.

What does this article bring up for us?

This article clearly highlights the proper management of fever in this type of patients. It also demonstrates that the evolution of an infection can be very fast and severe. Even though the clinical presentation is unspecific, an antibiotherapy should always be given without delay.