Recurrent pneumococcal OPSI after splenectomy: The need for optimized vaccination and prophylaxis.

Patients are known to be at an increased risk of sepsis post-splenectomy due to encapsulated organisms, such as Streptococcus pneumoniae. This is clinically important, as overwhelming post-splenectomy infection (OPSI) is very serious. Prevention, including vaccination, is recommended. Herein, we describe the case of a patient who survived a second attack of OPSI due to S. pneumoniae, serotype 34, that occurred 8 years after acute pericarditis related to S. pneumoniae-associated OPSI. The patient underwent a splenectomy due to malignant lymphoma and had been vaccinated with PPSV 23, but had not received any additional vaccinations since then. Serotype 34 is not covered by either PPSV23 or PCV13. This case highlights the importance of providing patients who have undergone splenectomy with more optimized vaccines, prophylaxis, and education to prevent OPSI, tailored to their immunocompromised status.