Abstract: Journal of Critical Care Research and Emergency Medicine

Abstract:
Overwhelming post-splenectomy infection (OPSI) is an aggressive and frequently fatal syndrome usually due to Streptococcus pneumoniae. It is a diagnostic dilemma to be addressed in an emergency based on nonspecific early presentation and aggressive course. This narrative review is based on a real-life clinical case and discusses pathophysiology, epidemiology, diagnosis, prognosis, and management of OPSI. A 68-year-old male with history of trauma splenectomy and no history of pneumococcal vaccination presented to the Emergency Department with fever, diarrhea and epigastric pain. Multiorgan failure (MOF) with coagulopathy due to pneumococcal sepsis developed within hours. This case emphasizes the need for early identification, empirical antibiotic management, and supportive care. Based on the last ten years of literature, the review will provide a useful perspective to emergency physicians on how to recognize OPSI early which will ultimately affect patient outcomes.