van Dijk G W, van Leeuwen H J, van Gijn J, Hoepelman I M
Afd. Neurologie, Universitair Medisch Centrum Utrecht, Postbus 85.500, 3508 GA Utrecht.
Ned Tijdschr Geneeskd. 2003 Mar 8;147(10):425-8.
Two female patients, aged 39 and 52 years, developed severe pneumococcal meningitis. Both patients had undergone splenectomy in the past (one after trauma and one for idiopathic thrombocytopenic purpura) and pneumococcal vaccination was only given immediately after the splenectomy. After antibiotic treatment and intensive care one patient remained disabled and the other patient died. There is a higher risk of developing severe sepsis after splenectomy, with Streptococcus pneumoniae being the causative micro-organism in more than 50% of cases. Vaccination after splenectomy in order to prevent a severe sepsis syndrome is very important. Indications for the 7 valent pneumococcal conjugate vaccine and the 23 valent polysaccharide vaccine are given.
两名女性患者，年龄分别为39岁和52岁，患上了严重的肺炎球菌性脑膜炎。两名患者过去均接受过脾切除术（一名因外伤，另一名因特发性血小板减少性紫癜），且仅在脾切除术后立即接种了肺炎球菌疫苗。经过抗生素治疗和重症监护，一名患者仍有残疾，另一名患者死亡。脾切除术后发生严重脓毒症的风险较高，超过50%的病例中肺炎链球菌是致病微生物。脾切除术后接种疫苗以预防严重脓毒症综合征非常重要。文中给出了7价肺炎球菌结合疫苗和23价多糖疫苗的适应证。
