Prevention of life-threatening infections due to encapsulated bacteria in children with hyposplenia or asplenia: a brief review of current recommendations for practical purposes.

The aim of the present work was to summarise in a single paper all the options for prevention of life-threatening infections due to encapsulated bacteria in patients with hyposplenism or asplenia. Prevention of these infections should be obtained in all patients with 1) patient and family education, 2) prophylaxis by means of vaccination against Haemophilus influenzae and Streptococcus pneumoniae, 3) antibiotic prophylaxis, based primarily on penicillin, 4) delay of elective splenectomy or use methods of tissue salvage in splenic trauma. Vaccination is not effective against all serotypes of S. pneumoniae and Neisseria meningitidis causing life-threatening infections in hypo/asplenic patients. Moreover, antibacterial prophylaxis could select antibacterial-resistant pathogens and is highly conditioned by patient's compliance. Therefore, empirical antibacterial therapy of fever and/or suspected infection should be recommended to all splenectomised patients independently from time elapsing from splenectomy, vaccinal status and assumption of antibacterial prophylaxis.