Enlarged spleen/splenomegaly?

[Used2bthin]

Dd had this at a recent hospital stay for her long term condition. In the chaos I didn't think to ask more about it till I read the discharge notes. She was treated with IV anti biotics for an unknown infection while there and there is no follow up other than the usual stuff.
Is this common with infections does anyone know? Thanks !

[dratsea]

The spleen is a bit like the oil filter in an engine, it clears the blood of infections and by forcing the blood cells through small gaps (think nitty gritty) it clears the cells of certain infection (encapsulated bacteria like pneumococcus) and removes any under performing cells. An enlarged spleen is the norm in many tropical places as it works hard to remove parasites like malaria. It also acts as a reservoir so that when you go from sitting to standing you need a bit more blood in the circulation and the spleen is sponge like and squeezes out enough to top up the circulation.

So, in answer to your question, chronic infection = big spleen.

[ArmfulOfRoses]

drat that is really interesting to read.
I had a splenectomy at 17 (34 now) and didn't know half of that.

Op, I hope your dd is feeling better now ☺

[Used2bthin]

Thanks so much for that dratsea that's really helpful. she had a probable throat infection they thought so sounds like would that explain it then? They had been very very worried as her infection markers were very high and they were talking about sepsis then suddenly a few days in she started to improve on the IV stuff.
Thanks Armfulofroses too I hope you're doing ok too.

[ArmfulOfRoses]

I'm fine, I opened the thread as I wondered if you were worried about the possibility of removal and was ready to tell you just how fine I am and so not to worry.
Obviously you weren't so was going to slink away but I just had to acknowledge that wonderful answer from drat.

[dratsea]

Roses 17 years ago not all the vaccinations now given post-splenectomy were available. You should have had pneumococcus every 5 years, Men C (but why not have the Men ACWY which is just being introduced) Hib but again if not had Men C then Hib/Men C would work and lastly you need annual flu jabs. The risk of infection after splenectomy is increased but I am guessing yours came out after fall from horse accident and "bits" will have been left behind. The risk after traumatic splenectomy still exists but the good news is that the older the splenectomy the lower the risk, and 17 almost counts as being old in that respect!. I did have an information sheet I gave to parents of children who "lost" their spleens, pm if you want me to try to find a copy. NHS Advice.

[ArmfulOfRoses]

Yes I had the meningitis one, pneumonia every 5 years (I am allergic to something in that one so causes a week of agony but better than pneumonia) and annual flu jab.
I had about a year on penicillin but then various Dr's told me different things re the value of this so I don't take it anymore.
I don't get ill often but I do get ill fast.

It was removed due to an illness/condition called itp, in which my spleen decided my platelets were bad for me so kept killing them off!

[Used2bthin]

Interesting armfulofroses as my dd's primary condition means she can't cope with illness or injury, different reasons but similar risk from infection, getting ill fast etc (quick google !)
Glad you are well. No one said anything further about my dd's spleen and I had forgotten to ask till I read the letter so I'm reassured it was just from the infection that she had .

[dratsea]

Roses ITP, yes, you need the jabs. It's an interesting op, basically you are made to wait until the last possible moment, just in case the steroids kick in, (they do not but the haematologist does not have to do the op), haematology book a month's worth of platelets and you do a smash and grab, once the spleen is unplugged pour in the platelets and hope the bleeding stops. The spleen is about x10 normal so to get at the vessels can be a challenge, first time I saw one was as baby doctor, second assistant, and as the surgeon struggled to roll the spleen towards him to get a clip on the splenic artery there was a gentle snap, steroids soften tissues, spleen came out in one, with about 1/4 cardiac output leaving a line of red over theatre sister, ceiling and the anaesthetist's Guardian. I (poser) had a pair of artery forceps in hand and, being on same side as surgeon, got a glimpse of, and clipped the artery, to stunned silence from all around. Later, as a consultant removing spleens for ITP my second assistant was usually a medical student but I made sure they had a pair of forceps in hand, just in case.

[ArmfulOfRoses]

Fascinating!
I had 3 or 4 courses of steroids to build up the platelets but they dropped so rapidly that I had the op.
used I am so sorry for derailing your thread

[IsitBrieyourelookingfor]

Did they test for EBV? That could cause 'throat infection' and splenomegaly

[Used2bthin]

Armfulofroses no problem! Interesting anyway !
Isitbrie- I'm not sure what that is? But nothing in notes about testing other than the usual stuff ,is it worth me asking or would she still be ill?

[walkingthrotreacle]

I am going to jump on the spleen bandwagon too, sorry!
Dratsea - your info is great thank you. My dd ( now 14) 12 at the time had her spleen removed due to a large cyst. We weren't provided with any info from the children's hospital ( I won't say which one!). They just said it wouldn't affect her life at all and antibiotics for a few weeks! Fortunately I checked with local doctors who got advice from haematology. Would it be possible for me to pm you too for info sheet please?

[dratsea]

treacle Where I should have a letter about splenic injury I have a chart of Easter Island. Same shape as a spleen but not a lot of help to you or your dd. On a mission to find it, will let you know if I do.

[dratsea]

treacle latest clinical guidelines from Starship. Sorry this is professional/clinical advice and very "medical" feel free to pm for translation of any terms. Will see if I can find my original parent guide but to be honest this, esp in respect of vaccinations etc, is more up to date.

[walkingthrotreacle]

Easter island would be nice but maybe not at the moment !!!
Many thanks for your help. Interestingly, the surgeon noticed an accessory spleen which was left intact just in case. Apologies again for interrupting original post.