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Cited by 84Pneumonia and Respiratory InfectionsImmunodeficiency and Autoimmune DisordersStreptococcal Infections and Treatments

Host Defense Against Streptococcus pneumoniae: The Role of the Spleen

Wara, D. W.·1981·Clinical Infectious Diseases
DOI 10.1093/clinids/3.2.299
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Abstract

The asplenic patient has an increased susceptibility to bacterial septicemia. Streptococcus pneumoniae is responsible for approximately 50% of the episodes. Although the incidence of septicemia varies among patients of different ages and with different underlying diseases, half of the patients with overwhelming post-splenectomy infection die. Increased susceptibility to overwhelming infection with blood-borne bacteria is due primarily to the absence of a major phagocytic mass with a large blood flow. In the nonimmune host the spleen plays an important role in the phagocytosis and clearance of blood-borne antigens. Asplenic infants younger than two years old or splenectomized patients with an underlying disease that impairs their ability to form specific antibody to S. pneumoniae are at maximal risk for septicemia. In addition, studies of asplenic animals and humans suggest that the spleen has a specific role in the production of antibody. Activation of the alternative complement pathway may be abnormal in patients with anatomical or functional asplenia. Defective clearance of blood-borne bacteria in the nonimmune host, a decrease in antibody formation, and abnormal activation of the alternative complement pathway may be additive defects that place the asplenic host at risk for overwhelming post-splenectomy infection.

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Crossref · 10.1093/clinids/3.2.299

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Authors
Wara, D. W.
Affiliations
University of California, San Francisco (US)
Corresponding author
Wara, D. W.
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
1981-03-01
Volume
3
Issue
2
Pages
299-309
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1093/clinids/3.2.299
OpenAlex
W2064146621
Cited by
84
References
55
Citations by year
2026: 1 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 3 · 2020: 1 · 2019: 1 · 2018: 1 · 2015: 1 · 2013: 1 · 2012: 2
FWCI
3.78
Type
journal article
Language
en
Open access
closed
Locations
  • Clinical Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
  • Life Sciences › Immunology and Microbiology › Immunology › Immunodeficiency and Autoimmune Disorders
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Streptococcal Infections and Treatments
Keywords
Streptococcus pneumoniae, asplenia, post-splenectomy infection, overwhelming infection, bacterial sepsis, spleen, phagocytosis, antibody production, alternative complement pathway, splenectomy, host defense
MeSH terms
Animals, Antibodies, Bacterial, Humans, Phagocytosis, Pneumococcal Infections, Spleen, Splenectomy, Sepsis

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