Measures to reduce risk of serious infection:
(1) For patients traveling to areas endemic for malaria or babesiosis, steps to reduce tick and mosquito bite exposure: clothing, insect repellants, netting and lifestyle changes. Patients traveling to areas with endemic malaria should receive prophylactic antimalarial medication.
(2) Immunization, with reboosting as needed:
(2a) pneumococcal polysaccharide vaccine
(2b) Hemophilus influenzae type B
(2c) Neisseria meningitidis vaccine
(2d) Influenza
(3) Consider use of an oral antibiotic for prophylaxis once-a-day.
(4) Conduct patient training and education. The patient should always care a medical alert identification card or bracelet.
(5) The patient's medical record should document the splenic dysfunction.
Measures when febrile or infected:
(1) If a fever develops, the patient should promptly self-treat with a suitable oral antibiotic.
(2) If a more serious infection is suspected, then admit to the hospital and immediately start empiric parenteral antibiotic therapy.
(3) If sepsis is suspected, then a rapid diagnostic techniques such as examination of buffy coat smears should be performed to identify the pathogen as soon as possible,
(4) For febrile patients with recent travel to an endemic area for malaria or babesiosis, peripheral blood smears should be carefully examined for parasites.
(5) Report any preceding animal exposures, especially bites or scratches from pets.
Issues in care:
(1) Asplenic patients may not respond to vaccination as well as the normosplenic person.
(2) The level of drug-resistant bacteria need to be monitored in order to help select the optimal prophylactic or treatment regimens.
(3) The presence of cellular or humoral immunodeficiency increases the risk of serious infection.
