Overwhelming postsplenectomy sepsis twenty-two years after operation risks management and prevention.

A new case of fatal postsplenectomy sepsis occurring 22 years after operation for splenic rupture is described. There are now 30 published cases in which this complication occurred 10 or more years after operation. The microorganism responsible for the vast majority of cases is Streptococcus pneumoniae. The causative pathogen identified in the present case was a Viridans Streptococcas, Strep. sanguis, an opportunistic, low virulence pathogen. The clinical presentation of this patient is characteristic of the syndrome of overwhelming postsplenectomy infection and exemplifies the dramatic suddenness with which it develops.