Hyposplenism may be:

Blood film in hyposplenism may show
  • Howell-Jolly bodies 
  • Acanthocytes 
  • Target cells 

Hyposplenism results in an increased risk of life-threatening infection, particularly by:
  • Encapsulated organisms such as 
    • Pneumococci 
    • Haemophilus influenzae 
    • Meningococci 
  • Intraerythrocytic parasites 
    • Plasmodia falciparum 
    • Babesia microti

Management of hyposplenism/asplenism:
  • Vaccination
    • Pneumococcal vaccine, Hib vaccine and meningococcal B and C vaccines 
    • Yearly influenza vaccination
  • Lifelong prophylactic antibiotics should be considered with either penicillin or macrolides

Small print gem: after splenectomy, the risk of overwhelming infection is greatest in the first 2 years.

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