The Overwhelming Postsplenectomy Infection Syndrome (OPSI) may occur in a patient who has had a splenectomy. It is associated with a high mortality rate, especially when not treated aggressively.
Features of OPSI:
(1) history of splenectomy, which may be recent or remote (highest risk in first 2 years)
(2) fulminant bacteremia and/or meningitis usually with an encapsulated organism
(3) septic shock with DIC
A patient with asplenia is at risk for a comparable syndrome.
Additional findings:
(1) no obvious focus of infection
(2) short, nonspecific prodrome
Risk factors:
(1) infant
(2) splenectomy for a hematologic disorder (versus trauma)
(3) immunodeficiency or immunsuppression
(4) failure to adequately vaccinate against encapsulated organisms
Common pathogens:
(1) Streptococcus pneumoniae
(2) Hemophilus influenzae
(3) Neisseria meningitidis
