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The spleen is an organ located in the upper left side of the abdomen, tucked under the rib cage, behind the stomach. It is normally about the size of a person's fist. The spleen produces antibodies and filters bacteria from the blood. This helps the body to fight infections.
People who had their spleen removed, or underwent high-dose radiation to the spleen (30 Gy - 3000 cGy/rads or higher) have a greater risk of developing serious infections. The types of infections most likely to occur in people without a functioning spleen are caused by encapsulated bacteria (germs with an outer coating that protect them from the body's immune system) and include Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria (meningococcal meningitis).
Fever is a sign of infection. Often, fever is caused by a virus (like the flu) and not by dangerous bacteria. However, there is no way to know if bacteria are the cause of a fever unless a blood culture is done. Unfortunately, it takes anywhere from a few hours to a few days for the blood culture results to become available. Therefore, whenever you have a fever you must be treated with antibiotics as if you had a serious infection, at least until the results of the blood culture is known.
Other symptoms of infection include unusual tiredness, muscle aches, chills, headache, vomiting, diarrhea, and abdominal pain. These symptoms can be warning signs of infection even if you do not have a fever. People at risk for infection should check with your healthcare provider if they develop these symptoms and should take their temperature regularly when ill.
If your temperature is 101°F (38.3°C) or higher:
Vaccines - Vaccines may reduce the chances of a serious infection. Patients without a spleen, or with a damaged one, are recommended to receive the Pneumococcal, Meningococcal, and HIB (Haemophilus influenzae type B) vaccines. Everyone should have at least one booster of Pneumococcal vaccine, given 3 to 5 years after the first shot. Some healthcare providers recommend additional boosters. Many healthcare providers also recommend yearly influenza (flu) vaccine to reduce the risk of bacterial infections that can sometimes occur as a complication of flu.
Antibiotics - Some healthcare providers recommend daily preventive (prophylactic) antibiotic pills, such as penicillin, to try to preventing serious bacterial infections. Others may have patients keep a prescription to have on hand with instructions to begin taking antibiotics at the first sign of illness. Still others may recommend a prescription for antibiotics only if traveling to an area where it will be difficult to obtain medical care. In any case, it is essential that people seek immediate medical attention any time they develop fever, chills, or other symptoms of serious illness. Delaying a medical visit for even a few hours can be very dangerous for those without a spleen or with a damaged one as bacterial infections can worsen rapidly.
Patients without a functioning spleen are at increased risk for problems with the following infections:
Be sure to tell all of your doctors, dentists, and other healthcare providers if you do not have a functioning spleen. Wear a medical alert emblem (bracelet or necklace) so if you are unable to communicate in a medical emergency, you will be readily identified as not having a functioning spleen. Carry a wallet card with guidelines for healthcare professionals regarding the management of fever in people without a functioning spleen.