[Overwhelming Postsplenectomy Infection after Cardiac Surgery in a Patient with Immune Thrombocytopenia;Report of a Case].

Splenectomy for immune thrombocytopenia (ITP) can increase the number of platelets. However, patients without functioning spleen become vulnerable to bacteria. Overwhelming post-splenectomy infection( OPSI), its most fulminant form, is rapidly progressive and is highly fatal. A 76-year-old male, who had undergone splenectomy for refractory ITP and taken a vaccination for treptococcus pneumoniae 4 years previously, was admitted to undergo cardiac surgery for severe aortic regurgitation and coronary disease. Prior to operation, high dose intravenous immunoglobulin therapy (400 mg/kg/day) for 5 days successfully increased platelet count. Surgery and early postoperative course were satisfactory. However, on 6th postoperative day, the patient had sudden high fever and became septic. After adequate antibiotic treatment for OPSI, the patient recovered well. Blood culture yielded methicillin-susceptible Staphylococcus aureus (MSSA). The patient discharged in good condition 30 days after the operation.