Asplenia — SCE Infectious Diseases MCQ
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Correct answer: E — Provide indicated pneumococcal, meningococcal and Hib vaccines before surgery when possible, annual influenza vaccination, antibiotic prophylaxis according to risk, and an emergency fever plan with review
The best answer is “Provide indicated pneumococcal, meningococcal and Hib vaccines before surgery when possible, annual influenza vaccination, antibiotic prophylaxis according to risk, and an emergency fever plan with review”. Asplenia creates particular vulnerability to encapsulated bacteria; prevention combines timed vaccination, risk-based antibiotics, education and rapid treatment access. “Give BCG alone because tuberculosis causes most post-splenectomy sepsis” is less appropriate because it conflicts with the decisive clinical feature or cited guidance. “Give MenACWY alone and no written fever advice” is less appropriate because it conflicts with the decisive clinical feature or cited guidance. “Wait until after sepsis occurs before vaccinating” is less appropriate because it conflicts with the decisive clinical feature or cited guidance. “Use daily antifungal prophylaxis instead of encapsulated-bacterial prevention” is less appropriate because it conflicts with the decisive clinical feature or cited guidance.
Reference: UKHSA Green Book chapter 7: immunisation of people with underlying conditions: https://www.gov.uk/government/publications/immunisation-of-individuals-with-underlying-medical-conditions-the-green-book-chapter-7