Guidelines for the management of adult patients with an absent or poorly functioning spleen.

Asplenic patients are at a greater risk of developing fulminant, life-threatening sepsis and so must be appropriately vaccinated and receive antibiotic prophylaxis. The main causative organisms are:

• Streptococus pneumoniae
• Haemophilus influenzae
• Neisseria meningitidis.

The management of the patient varies slightly depending on the circumstances of the operation (elective vs emergency). Also note the guidelines will not apply to every patient but should be adapted appropriately.

• Elective splenectomy
• Emergency splenectomy.
• General advice:
  • Identification of asplenic patients
  • Chemotherapy or immunosuppressive therapy
  • Pregnant or breast feeding
  • Travel
  • Patient planning a pilgrimage to the Haj or Umrah?
  • Animal bites
  • Tick bites
  • Infection
• All information regarding immunisations given and the intended antibiotic prophylaxis regimen should be conveyed to the patient's GP (a pre-printed letter is available).
• A Patient information leaflet has also been produced and should be offered to all patients (these are also available on ward E15 QMC campus).

Page last edited: 20/05/2009

Caution; the antibiotic doses recommended on this website are intended for adult patients with normal renal and liver function unless otherwise stated. Dosing advice for patients with renal impairment is available here.

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