Asplenia medical treatment: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
===Emergency Medical Management of suspected sepsis in Asplenic patient=== | |||
*Children with [[asplenia]] for every [[febrile illness]], must be seen by a physician immediately.<ref name="pmid24855431">{{cite journal| author=Salvadori MI, Price VE, Canadian Paediatric Society, Infectious Diseases and Immunization Committee| title=Preventing and treating infections in children with asplenia or hyposplenia. | journal=Paediatr Child Health | year= 2014 | volume= 19 | issue= 5 | pages= 271-8 | pmid=24855431 | doi= | pmc=4029242 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24855431 }} </ref> | |||
*[[Sepsis]] in individuals with [[asplenia]] or [[hyposplenia]] is a [[medical emergency]] as these [[patients]] can die within several hours of [[fever]] onset despite appearing well initially. | |||
*[[Administration]] of [[antibiotic]] therapy should not be delayed and [[blood culture]] should be performed unless there is an obvious [[nonbacterial source]]. | |||
*[[Ceftriaxone]]: [[100 mg/kg/dose]], [[(maximum 2 g/dose)]] should be given in all [[asplenic patients]]. | |||
*[[Administer]] both [[ceftriaxone]] and [[vancomycin]] (60 mg/kg/day in divided doses every 6 h) in case of [[intermediate]] or [[high penicillin-resistant pneumococci]]. | |||
*If the [[patient]] is treated in a [[clinic]] or [[office setting]], refer [[immediately]] to the nearest [[emergency department]]. | |||
*Clinical [[deterioration]] can be rapid even after [[antibiotic administratin]] so changes in [[antibiotics]] should be done after [[culture reports]] available. | |||
*[[Vancomycin]] and [[ciprofloxacin]] can be used if the patient has an [[allergy]] to [[penicillin]] or [[cephalosporin]]. Changes in [[antibiotics]] should be done after [[culture]] reports available. | |||
Revision as of 09:20, 15 July 2021
Medical Therapy
Emergency Medical Management of suspected sepsis in Asplenic patient
- Children with asplenia for every febrile illness, must be seen by a physician immediately.[1]
- Sepsis in individuals with asplenia or hyposplenia is a medical emergency as these patients can die within several hours of fever onset despite appearing well initially.
- Administration of antibiotic therapy should not be delayed and blood culture should be performed unless there is an obvious nonbacterial source.
- Ceftriaxone: 100 mg/kg/dose, (maximum 2 g/dose) should be given in all asplenic patients.
- Administer both ceftriaxone and vancomycin (60 mg/kg/day in divided doses every 6 h) in case of intermediate or high penicillin-resistant pneumococci.
- If the patient is treated in a clinic or office setting, refer immediately to the nearest emergency department.
- Clinical deterioration can be rapid even after antibiotic administratin so changes in antibiotics should be done after culture reports available.
- Vancomycin and ciprofloxacin can be used if the patient has an allergy to penicillin or cephalosporin. Changes in antibiotics should be done after culture reports available.