Sepsis and the Spleen

Author(s): Ruy Garcia Marques

Pp: 84-116 (33)

DOI: 10.2174/978160805273811101010084

* (Excluding Mailing and Handling)

Abstract

Since ancient times, the spleen is regarded as a mysterious and intriguing organ. It has various functions underscoring its prepoderant relevance as the largest secondary lymphoid organ system. Total splenectomy done at any age and for any reason increases the risk of death from overwhelming postsplenectomy infection (OPSI). The etiologic agents most frequently found in OPSI are Streptococcus pneumoniae, Haemophilus influenzae type B, and Neisseria meningitidis, but other bacteria such β-hemolytic Streptococcus, Staphylococcus aureus, and Escherichia coli, Pseudomonas sp., also present a significant risk. Prophylaxis of OPSI is located in three main categories: patient education, immunoprophylaxis, and chemoprophylaxis. Besides these, the realization of heterotopic splenic autotransplantation after splenectomy seems to favor the recovery of some of the functions of the spleen. However, these measures seem to be not sufficient to prevent the higher risk of developing OPSI. Because of this risk, the indication for the realization of total splenectomy in trauma and several diseases has been sharply declining. The objective of this work is to make a description of the aspects that correlate the absence of spleen with the occurrence of sepsis.


Keywords: Overwhelming postsplenectomy infection. Spleen. Splenectomy. Prophylaxis. Splenic auto-implant. Sepsis.

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      • 13. app/Models/UserAccess/UserAccess.php:1266
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      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 316323591 and j.to_ip >=316323591 )) and ((j.from_date <= 1740773839 and j.to_date >= 1740773839 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 2392) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 316323591 and j.to_ip >=316323591 )) and ((j.from_date <= 1740773839 and j.to_date >= 1740773839 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 2392) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 316323591 and j.to_ip >=316323591 )) and ((j.from_date <= 1740773839 and j.to_date >= 1740773839 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 2392)
      1.03msalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 956 and `b`.`banner_from_date` <= 1740773839 and `b`.`banner_to_date` >= 1740773839 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.5msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 956
      • 3: 1740773839
      • 4: 1740773839
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='dac3536109a75fb2ca4f7f36780378b3'
      10.84msalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:291
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Keywords
    1Keywords.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        rdDh09b8Znoj7smQbpDLFxylyEU0bk89mVGBwV0D
        uc_cart_id
        dac3536109a75fb2ca4f7f36780378b3
        _previous
        array:1 [ "url" => "http://alpha.eurekaselect.com/chapter/2392" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/2392
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
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        request_cookies
        0 of 0
        array:1 [ "wayfindertarget" => null ]
        response_headers
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        session_attributes
        0 of 0
        array:5 [ "_token" => "rdDh09b8Znoj7smQbpDLFxylyEU0bk89mVGBwV0D" "uc_cart_id" => "dac3536109a75fb2ca4f7f36780378b3" "_previous" => array:1 [ "url" => "http://alpha.eurekaselect.com/chapter/2392" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-28 20:17:19GET/chapter/2392112193