Septicemia and Disseminated Intravascular Coagulation

Abstract

THERE is considerable diversity of opinion concerning the susceptibility of splenectomized patients to serious bacterial infections.^1-4 The major determinant in assessing the risk of infection in such patients is thought to be the underlying condition necessitating splenectomy. In conditions affecting the reticuloendothelial system (eg, thalassemia, Gaucher's disease, and malignancy), the incidence of infection is increased.^1,4 However, splenectomy in patients with idiopathic thrombocytopenia purpura or trauma to the spleen does not appear to impose a greater than normal risk of bacterial infection.^1,2 The age at which splenectomy is performed may also be important, since the incidence of septicemia and meningitis under 1 year of age in these patients is abnormally high.¹ Although the frequency of postsplenectomy infection does not appear to be higher than normal in older infants and children, mortality from those infections that do occur is considerable,¹ indicating that disease in children without spleens