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Colegio de Medicina Interna de México.

2014, Número 5

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Med Int Mex 2014; 30 (5)


Síndrome de sepsis grave posesplenectomía secundario a Streptococcus pneumoniae en trasplante hepático

Carrillo-Esper R, Peña-Pérez CA, de los Monteros-Estrada IE, de la Torre-León T, Rosales-Gutiérrez AO, Nava-López JA, Zepeda-Mendoza AD, Pérez-Calatayud ÁA, Díaz-Carrillo MA, Rangel-Olascoaga CR, Lazcano-Romero I

Idioma: Español
Referencias bibliográficas: 53
Paginas: 591-601
Archivo PDF: 778.99 Kb.


RESUMEN

Los pacientes esplenectomizados o con hipoesplenia son susceptibles a padecer infecciones y sepsis grave (posesplenectomía). Comunicamos el caso de un paciente que padeció síndrome de sepsis posesplenectomía secundario a Streptococcus pneumoniae siete años después de practicarle esplenectomía por trombosis mesentérica y daño en la vena esplénica y antecedente de haberse sometido a trasplante hepático ortotópico. El síndrome de sepsis posesplenectomía tiene elevada mortalidad, su evolución es fulminante, las manifestaciones son graves y el pronóstico es malo. Es fundamental que los enfermos 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 de seguimiento de pacientes esplenectomizados y de la profilaxis, diagnóstico y tratamiento del síndrome de sepsis posesplenectomía, así como difundir entre los enfermos esplenectomizados y con disfunción esplénica y el grupo médico tratante programas educativos relacionados con esta enfermedad.


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