[Fulminant infection in a splenectomized patient with Hodgkin disease. Fatal pneumococcal meningitis in a cured patient seven years after splenectomy].

Ten years ago, because of the increasing number of patients recovering from Hodgkin disease, some authors advocated systematic laparotomy with splenectomy for more accurate staging in order to adjust therapy with more precision. This attitude now seems questionable because of the occurence of several complications, particularly of life-threatening infections, which can be fatal even after recovery from Hodgkin disease. The case of a twenty-three-year-old male patient with Hodgkin disease stage III A, histological grade I, is reported. MOPP chemotherapy, splenectomy and cobalt radiotherapy were followed by complete recovery. Seven years later the patient died from fulminant pneumococcal meningitis. A review of previously published cases show that prolonged prophylaxis with oral penicillin is mandatory in splenectomized patients. Immunization with the pneumococcal polysaccharide vaccine should be attempted even though the long-term results are still unknown.