Splenectomy

[zmeister22]

Because I'm a first year and don't really know a damn thing yet, I need to ask you guys an honest question. I have been told that after a splenectomy a major risk is death from infection by encapulated bacteria (mainly pneumococcus, H. influenza and meningococcus). I know from experience that as an EM physician, I can pretty much count on one of those getting coughed in my face each day. I've had the pneumococci and meningococci vaccines and get the flu shot asap each year. If the splenectomy did have to happen, would EM just not be a good choice? I know that every specialty will have contact with these things, but EM just seems like one of the worst. Thanks guys and gals.

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[Drawing Dead]

Unless you are going to inhale the constant GC/Chlamydia/Trich that makes up the bulk of the infections that I treat, I would assume you are probably safer in the ED than say on the medicine floors or ICU, where there is a higher percentage of patients who are septic, or have pneumonia.

I would have to assume that as a young and otherwise healthy person, and you get your vaccinations, you are probably ok. That question would probably be better answered by an ID doc than EM though. If you are really that concerned about sick contacts, maybe consider Anesthesia, Rads, or other fields that offer less sick contact or more sterile environments.

 

[Seaglass]

I would say that my impression is that the recent advances in antibiotics have really made issues of splenectomy less significant than they used to be. Certainly you need to continue to be aware of it and more cautious with those patients but it's not the same risk it used to be.

 

[Seaglass]

And EM is not that big a deal as far as ID exposure.

 

[had2piknowEM]

And also, the flu shot doesn't protect against H. influenza, although your childhood immunizations protect against some strains of it. The flu shot is for the Influenza virus. But like the others above, I recommend consulting an ID doc or hopping over to the ID forum in Internal Medicine.

 

[Toohotinvegas33]

Zmeister22 dont worry, all medically relevent knowledge will come in 2nd year, and you go over bits of biochem/immuno/phys/anatomy in each system course when it applies