medigraphic.com

2014, Número 2

<< Anterior Siguiente >>

Rev Fac Med UNAM 2014; 57 (2)


Síndrome de sepsis grave postesplenectomía secundario a meningococcemia

Carrillo ER, Peña PCA, Carrillo CJR, Carrillo CLD, Carrillo CCA, Carrillo CDM

Idioma: Español
Referencias bibliográficas: 55
Paginas: 31-41
Archivo PDF: 260.86 Kb.


RESUMEN

Los pacientes esplenectomizados o con hipoesplenia son susceptibles a desarrollar infecciones y sepsis grave. A esta entidad se le denomina sídrome de sepsis postesplenectomía (SSPE). Reportamos el caso de una paciente que presentó SSPE secundario a Neisseria meningitidis serogrupo CR7, 10 años después de practicársele esplenectomía por púrpura trombocitopénica idiopática. El SSPE tiene una elevada mortalidad, su evolución es fulminante, las manifestaciones son graves y el pronóstico es malo. Es fundamental que los pacientes esplenectomizados sean vacunados, reciban antibióticos profilácticos y atención médica ante cualquier manifestación de un proceso infeccioso. Es prioritario implementar una política de salud pública para el desarrollo de guías relacionadas al seguimiento de los pacientes esplenectomizados y sobre aJefe de la Unidad de Terapia Intensiva. Fundación Clínica Médica Sur. México, DF. bResidente de Medicina del Enfermo en Estado Crítico. Fundación Clínica Médica Sur. México, DF. cResidente de Cirugía. Instituto Nacional de Ciencias Médicas y Nutrición Salvador. México, DF. dPasante de Servicio Social. Fundación Clínica Médica Sur. México, DF. eEstudiante de Medicina. Facultad de Medicina. UNAM. México, DF. Correo electrónico: revistacma95@yahoo.com.mx Recibido: 10-04-12. Aceptado: 20-10-12. la profilaxis, diagnóstico y manejo del SSPE, y difundir entre los pacientes esplenectomizados y con disfunción esplénica así como al grupo médico tratante programas educacionales relacionados con esta enfermedad.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Weintraub LR. Splenectomy: Who, when and why? Hosp Pract. 1994;29:27-34.

  2. Rowley DA. The formation of circulating antibody in the splenectomized human being following intravenous injection of heterologous erythrocytes. J Immunol. 1950: 65;515-1.

  3. Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, et al. Surviving Sepsis Campaing: International guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med. 2008;36:296-327.

  4. Hosea SW, Brown EJ, Hamburger MI, Frank MM. Opsonic requirements for intravascular clearance after splenectomy. N Engl J Med. 1981;304:245.

  5. Styrt B. Infection associated with asplenia: risks, mechanisms, and prevetion. Am J Med. 1990;88:33N.

  6. Lynch AM, Kapila R. Overwhelming postsplenectomy infection. Infect Dis Clin North Am. 1996;4:693-707.

  7. Green JB, Shackford SR, Sise MJ, Fridlund P. Late septic complications in adults following splenectomy for trauma: A prospective analysis in 144 patients. J Trauma. 1986; 26:999-1004.

  8. Brigden ML. Overwhelming post-splenectomy infectionstill a problem. West J Med. 1992;157;440-3.

  9. Jones P, Leder K, Woolley I, Cameron P, Cheng A, Spelman D. Postsplenectomy infection. Strategies for prevention in general practice. Australian Family Physician. 2010; 39:383-6.

  10. Morris DH, Bullock FD. The importance of the spleen in resistance to infection. Ann Surg. 1919:70;513-21.

  11. O’Donnell FJ. The value of splenectomy in Banmti’s disease. Br Med J. 1929:i;824.

  12. King H, Shumacker HB Jr. Susceptibility to infection after splenectomy performed in infancy. Ann Surg. 1952: 136;239-42.

  13. Schwartz PE, Sterioff S, Mucha P, Melton III LJ, Offord KP. Postsplenectomy sepsis and mortality in adults. JAMA. 1982;248:2279-83.

  14. Demeshek W. Hypoesplenism. JAMA. 1955;157:613.

  15. Doll DC, List AF, Yarbro JW. Functional hyposplenism. South Med J. 1987;80:999-1006.

  16. Di Sabatino A, Carsetti R, Corazza GR. Post-splenectomy and hyposplenic states. Lancet. 2011;378:86-97.

  17. Weitzman S, Aisenberg AC. Fulminant sepsis after the successful treatment of Hodgkin’s disease. Am J Med. 1977;62:47.

  18. Kyaw MH, Holmes EM, Toolis F, Wayne B, Chalmers J, Jones IG, et al. Evaluation of severe infection and survival after splenectomy. Am J Med. 2006;119:276.e1-276.e7.

  19. Gopal V, Bisno AL. Fulminant pneumococcal infections in “normal” asplenic hosts. Arch Intern Med. 1977;137:1526.

  20. Zarrabi MH, Rosner F. Serious infections in adults following splenectomy for trauma. Arch Intern Med. 1984; 144:1421.

  21. Thomsen RW, Schoonen WM, Farkas DK, Riis A, Jacobsen J, Fryzek JP, et al. Risk for hospital contact with infection in patients with splenectomy: a population-based cohort study. Ann Intern Med. 2009;151:546-555.

  22. Stryker RM, Orton DW. Overwhelming postsplenectomy infection. Ann Emerg Med. 1988;17:161-164.

  23. Cullingford GL, Watkins DN, Watts AD, Mallon DF. Severe late postsplenectomy infection. Br J Surg. 1991; 78:716-21.

  24. Holdsworth R, Irving A, Cuschieri A. Postsplenectomy sepsis and its mortality rate actual versus perceived risks. Br J Surg. 1991;78:1031-8.

  25. Brigden ML. Overwhelming postsplenectomy infection – Still a problem. West J Med. 1992;157:440-3.

  26. Green JB, Shackford SR, Sise MJ, Fridlund P. Late septic complications in adults following splenectomy for trauma: A prospective analysis in 144 patients. J Trauma. 1986; 26:999-1004.

  27. Spencer SP, Gupta SM. The spleen: diagnosis of splenic diseases using radiolabeled tracers. Crit Rev Lab Sci. 1989; 27:299-318.

  28. Peter AM, Ryan PFJ, Klonizakis I, Elkon KB, Lewis SM, Hughes GRW. Measurement of splenic function in humans using heat damaged autologous red blood cells. Scand J Haematol. 1981;27:374-80.

  29. Corazza GR, Ginaldi L, Zoli G, Frisoni M, Lalli G, Gasbarrini G, et al. Howell-Jolly body counting as a measure of splenic function: A reassessment. Clin Lab Haematol. 1990;12:269-75.

  30. Lane PA, O’Connell JL, Lear JL, Rogers ZR, Woods GM, Hassell KL, et al. Functional asplenia in hemoglobin SC disease. Blood. 1995;85:2238-44.

  31. Department of Health. Immunisation Against Infectious Disease (The Green Book) HMSO, London 2010. (Citado el 9 septiembre de 2011). Disponible en: http://www. dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/ DH_079917.

  32. Working party of the British Committee for Standards in Haematology Clinical Haematology Task Force. Guidelines for the prevention and treatment of infection in patients with an absent of dysfunctional spleen. BMJ. 1996; 312:430-4.

  33. Stanford E, Print F, Falconer M, Lamden K, Ghebrehewet S, Phin N, et al. Immune response to pneumococcal conjugate vaccine in asplenic indivicuals. Human Vaccination. 2009;5:85-91.

  34. Balmer P, Cant AJ, Borrow R. Antipneumococcal antibody titre measurement: what useful information does it yield? Journal of Clinical Pathology. 2007;60:345-50.

  35. Shatz DV. Vaccination considerations in the asplenic patient. Expert Rev Vaccines. 2005;4:27-34.

  36. Harji DP, Jaunoo SS, Mistry P, Nesargikar PN. Immunoprophylaxis in asplenic patients. International Journal of Surgery. 2009;7:421-3.

  37. Musher DM, Ceasar H, Kojic EM, Musher BL, Gathe JC Jr, Romero-Steiner S, White AC Jr. Administration of protein-conjugate pneumococcal vaccine to patients who have invasive disease after splenectomy despite their having received 23-valent pneumococcal polysaccharide vaccine. J Infect Dis. 2005;191:1063-7.

  38. Whitney CG. Preventing pneumococcal disease. ACIP recommends pneumococcal polysaccharide vaccine for all adult age > or = 65. Geriatrics. 2003;58:20-22,25.

  39. Davies JM, Barnes R, Milligan D. Update of guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen. Clin Med. 2002;2:440-3.

  40. Davies JM, Lewis MP, Wimperis J, Rafi I, Ladhani S, Bolton-Maggs PH. Review of guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen: Prepared on behalf of the British Committee for Standards in Haematology by a Working Party of the Haemato-Oncology Task Force. British Journal of Haematology. 2011;155:308-17.

  41. Jockovich M, Mendelhall NP, Sombeck MD, Talbert JL, Copeland EM 3rd, Bland KI. Long-term complications of laparotomy in Hodgkin’s disease. Ann Surg. 1994;219: 615-21;discussion 621-4.

  42. Ambrosino DM, Siber GR. Simultaneous administration of vaccines for Haemophilus influenzae type B, pneumococci and meningococci. J Infect Dis. 1986;154:893-6.

  43. Salisbury DM, Begg NT, editors. Immunisation against infectious disease. London: HMSO; 1996.

  44. Mourtzzoukou E, Pappas G, Peppas G, Falgas ME. Vaccination of asplenic or hyposplenic adult. Br J Surg. 2008; 95:273-80.

  45. Pao M, Papadopoulos EB, Chou J, Glenn H, Castro-Malaspina H, Jakubowski AA, et al. Response to pneumococcal (PNCRM7) and Haemophilus influenzae conjugate vaccine (HIB) in paediatric and adult recipients of an allogeneic hematopoietic stem cell transplantation (alloHCT). Biology of Blood and Marrow Transplantation. 2008;14:1022-30.

  46. Salisbury DM, Begg NT, editors. Immunisation against infectious disease. London: HMSO; 1996.

  47. Snape MD, Perret KP and Ford KJ. Immunogenicity of a tetravalent meningococcal glycoconjugate vaccine in infants; a randomized controlled trial. Journal of the American Medical association. 2008;299:173-84.

  48. Riddington C, Owusu-Ofori S. Prophylactic antibiotics for preventing pneumococcal infection in children with sickle cell disease. Cochrane Database Systematic Review, 2002; Issue 3, CD003427.

  49. Cummins D, Heuschkel R, Davies SC. Penicillin prophylaxis in children with sickle cell disease in Brent. British Medical Journal. 1991;302:989-90.

  50. William BM, Thawani N, Sae-Tia S, Corazza GR. Hyposplenism: a comprehensive review. Part II: clinical manifestations, diagnosis and treatment. Haematology. 2007; 12:89-98.

  51. Malangoni MA, Dillon LD, Klamer TW, Condon RL. Factors influencing the risk of early and late serious infection in adult after splenectomy for trauma. Surgery. 1984;96:775-83.

  52. Keenan RD, Boswell T, Milligan DW. Do post-splenectomy patients take prophylactic penicillin? British Journal of Haematology. 1999;105:509-10.

  53. Spickett GP, Bullimore J, Wallis J, Smith S, Sounders P. Northern region asplenia register analysis of first two years. Journal of Clinical Pathology. 1999;52:424-9.

  54. Davidson RN, Wall RA. Prevention and management of infections in patients without a spleen. Clin Microbiol Infect. 2001;7:657-60.

  55. Woolley I, Jones P, Spelman D, Gold L. Cost-effectiveness of a post-splenectomy registry for prevention of sepsis in the asplenic. Australian and New Zealand Journal of Public Health. 2006;30:558-61.




2020     |     www.medigraphic.com