Overwhelming postsplenectomy infection in patients with thalassemia major.

The efficacy of pre- and post-operative protection against overwhelming postsplenectomy infection was evaluated in a prospective study of 98 patients with thalassemia major. All patients were vaccinated four to ten weeks pre-operatively with a polyvalent antipneumonococcal vaccine; after their discharge from the hospital they received 1,000,000 units (625 mg) of oral penicillin daily for one to two years and have been closely followed up since then. The incidence of overwhelming infection among our patients was 1.02%. This very low incidence suggests that vaccination and prophylactic penicillin administration, combined with careful follow-up, provide adequate protection against overwhelming infection in splenectomized patients with thalassemia major.