Abstract

Two fatal cases of pneumococcal meningitis occurring in adults who had undergone splenectomy several years previously are described, and the literature relating to pneumococcal sepsis in asplenic patients is reviewed. There is a specific predisposition to pneumoccal sepsis. Asplenic patients presenting with the Waterhouse-Friderich-sen syndrome have a high mortality, but those presenting with meningitis or septicaemia have a similar mortality to normal people. Patients undergoing splenectomy for the staging of Hodgkin’s disease may run a greater risk of serious sepsis than asplenic patients in general. There is no evidence that the risk is greatest during the first 3 years following splenectomy. The prophylaxis and management of infection in asplenic patients are discussed. It is possible that knowledge of the problem in the asplenic patient may reduce the mortality.