Overwhelming postsplenectomy infection still a problem.

Despite an extensive medical literature over the past ten years, patients continue to die needlessly of overwhelming postsplenectomy infection. Although physicians have become increasingly cognizant of this syndrome in children, many remain unaware of the risk to asplenic or hyposplenic adults with no underlying medical problems. In addition, many older asplenic or functionally hyposplenic persons are unaware that they are at risk for this syndrome. The identification of Howell-Jolly bodies on a peripheral blood smear should alert physicians to the need for further follow-up to establish hyposplenism and to consider possible antipneumococcal vaccination.