Dalak Yokluğu ve Fonksiyon Bozukluğunda Ateş
Özet
Dalak vücudun ikinci büyük bağışık organı olup, kanı yabancı maddelerden temizler. Herhangi bir nedenle dalak yokluğu veya fonksiyon bozukluğunda ise bu işlevini yerine getiremeyeceği için, vücut özellikle kapsüllü bakteriler olmak üzere pek çok patojene açık hale gelir. Ateş, dalak fonksiyonu bozuk olan hastalarda sepsisin en erken bulgusudur ve hızlıca müdahale edilmelidir. İlk tanı değerlendirmesinden sonra hemen ampirik antibiyotik başlanmalı ve sonrasında kültür sonuçlarına göre tedavisi düzenlenmelidir. Bu hastalarda sepsisin erken tanınması ve uygun tedavinin hızlı bir şekilde başlanması, ölüm oranını büyük ölçüde azaltmaktadır. Bununla birlikte hasta eğitimi, aşılama ve profilaktik antibiyotik kullanımı da hayati öneme sahiptir.
Referanslar
Gazi U, Djursun K, Ayşe Semra G. Turk Hij Den Biyol Derg, 2019; 76(1): 109 - 122 1
Mark S P. Clinical features, evaluation, and management of fever in patients with impaired splenic function, Uptodate 2024
Pearse G. Normal Structure, Function and Histology of the Thymus. Toxicol Pathol, 2006; 34 (5): 504–14.
Damilola A, Roberto F. StatPearls [Internet]. Treasure Island (FL) 2024
Grace M Lee. Hematology Am Soc Hematol Educ Program. 2020 Dec 4;2020(1):328–335.
Nakagami Y, Uchino K, Okada H, et al. Potential role of Howell-Jolly bodies in identifying functional hyposplenism: a prospective single-institute study. Int J Hematol 2020; 112:544.
Tominaga GT, Simon FJ Jr, Dandan IS, et al. Immunologic function after splenic embolization, is there a difference? J Trauma 2009; 67:289.
Lammers AJ, de Porto AP, Bennink RJ, et al. Hyposplenism: comparison of different methods for determining splenic function. Am J Hematol 2012; 87:484.
Mark S P Prevention of infection in patients with impaired splenic function. Uptodate.2024
Robert Bona, Elective (diagnostic or therapeutic) splenectomy. Uptodate, 2024
Theilacker C, Ludewig K, Serr A, et al. Overwhelming Postsplenectomy Infection: A Prospective Multicenter Cohort Study. Clin Infect Dis. 2016;62(7):871-878. doi:10.1093/cid/civ1195.
Marrie TJ, Tyrrell GJ, Majumdar SR, Eurich DT. Asplenic patients and invasive pneumococcal disease-how bad is it these days?. Int J Infect Dis. 2016;51:27-30. doi:10.1016/j.ijid.2016.08.022.
Sylvia Yeah, Epidemiology, clinical manifestations, diagnosis, and treatment of Haemophilus influenzae. Uptodate, 2023.
Michael Apicella. Clinical manifestations of meningococcal infection. Uptodate, 2023
Marcia B.G. Capnocytophaga. Uptodate. 2024
Laura F.P., Klara M. Bordetella holmesii infection: current knowledge and a vision for future research, Expert Rev Anti Infect Ther, 2015 Aug;13(8):965-71.
Panagopoulos MI, Saint Jean M, Brun D, et al. Bordetella holmesii bacteremia in asplenic children: report of four cases initially misidentified as Acinetobacter lwoffii. J Clin Microbiol. 2010;48(10):3762-3764. doi:10.1128/JCM.00595-10.
Peter J Krause, Edouard G Vannier. Babesiosis: Clinical manifestations and diagnosis. Uptodate 2024
Herwaldt BL, Linden JV, Bosserman E, Young C, Olkowska D, Wilson M. Transfusion-associated babesiosis in the United States: a description of cases. Ann Intern Med. 2011;155(8):509-519. doi:10.7326/0003-4819-155-8-201110180-00362.
Brennan MB, Herwaldt BL, Kazmierczak JJ, et al. Transmission of Babesia microti Parasites by Solid Organ Transplantation. Emerg Infect Dis. 2016;22(11):1869-1876. doi:10.3201/eid2211.151028.
Joseph JT, Purtill K, Wong SJ, et al. Vertical transmission of Babesia microti, United States. Emerg Infect Dis. 2012;18(8):1318-1321. doi:10.3201/eid1808.110988.
Krause PJ, Gewurz BE, Hill D, et al. Persistent and relapsing babesiosis in immunocompromised patients. Clin Infect Dis. 2008;46(3):370-376. doi:10.1086/525852
Demar M, Legrand E, Hommel D, et al. Plasmodium falciparum malaria in splenectomized patients: two case reports in French Guiana and a literature review. Am J Trop Med Hyg 2004; 71:290.
Faryal Tahir, Jawad Ahmed, Farheen Malik. Post-splenectomy Sepsis: A Review of the Literature. Cureus. 2020 Feb 6;12(2):e6898.
Kimberlin DW, Banerjee R, Barnett ED, Lynfield R, Sawyer MH. American Academy of Pediatrics. Haemophilus influenzae infections. In: Red Book: 2024-2027 Report of the Committee on Infectious Diseases, 33rd ed p.400.
Nakamura K, Doi K, Okamoto K, et al. Specific antibody in IV immunoglobulin for postsplenectomy sepsis. Crit Care Med 2013; 41:e163.
Mark S. P. Prevention of Infection in Patients With Impaired Splenic Function, Uptodate. 2024.
Theilacker C, Ludewig K, Serr A, et al. Overwhelming Possplenectomy Infection: A Prospective Multicenter Cohort Stuy. Clin Infect Dis 2016; 62:871.
