Which organism is classically associated with sepsis in asplenic or functionally asplenic patients with sickle cell disease?

Which organism is classically associated with sepsis in asplenic or functionally asplenic patients with sickle cell disease?

• A. Streptococcus pneumoniae
• B. Staphylococcus aureus
• C. Escherichia coli
• D. Pseudomonas aeruginosa

Answer: (A)

The spleen clears encapsulated bacteria from the bloodstream, and in sickle cell disease repeated splenic infarctions lead to autosplenectomy or functional asplenia, reducing this defense. Streptococcus pneumoniae is the classic pathogen in this scenario because its polysaccharide capsule resists phagocytosis, so without splenic function the risk of fulminant pneumococcal sepsis is high. While Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa can cause bacteremia, they are not the organism most characteristically linked to sepsis in asplenic patients with sickle cell disease; the pneumococcus association is the hallmark. Vaccination and prophylaxis help prevent this risk.

The spleen clears encapsulated bacteria from the bloodstream, and in sickle cell disease repeated splenic infarctions lead to autosplenectomy or functional asplenia, reducing this defense. Streptococcus pneumoniae is the classic pathogen in this scenario because its polysaccharide capsule resists phagocytosis, so without splenic function the risk of fulminant pneumococcal sepsis is high. While Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa can cause bacteremia, they are not the organism most characteristically linked to sepsis in asplenic patients with sickle cell disease; the pneumococcus association is the hallmark. Vaccination and prophylaxis help prevent this risk.