What role does the spleen play?

Your spleen plays an important part in your resistance to infection (immunity). Your spleen is in the upper left side of your abdomen, partly protected by your lower ribs. The spleen may have to be taken out (splenectomy) or may stop working right for many reasons.

What if my spleen has to be taken out?

If your spleen has to be taken out, you may have an increased risk of severe infection. The degree of risk depends on your age and if you have other diseases. Although your risk of infection is highest in the first two years after splenectomy, it stays high for the rest of your life. With no spleen, the risk of a severe infection is about the same as dying in a home accident.

When should I call my doctor?

If your spleen has been taken out or is not working right, you should see your doctor at the first sign of infection, such as fever or chills. Other conditions that you should see your doctor for are a severe sore throat, an unexplained cough, severe abdominal pain, and headache or drowsiness.

What can I do to reduce the risk of infection?

Doctors, dentists and other health care workers should always be told if you have no spleen. You should also wear a MedicAlert bracelet or necklace from the MedicAlert emergency medical information service. You can get one by contacting MedicAlert Foundation International, 2323 Colorado Ave., Turlock, CA 95382. Their toll-free number is 1-800-432-5378. Their Web site address ishttp://www.medicalert.org.

You should get vaccinated against pneumococcal infection. You should get a booster shot of the vaccine every 3 to 5 years. Your doctor may also want you to get two other shots, one against Haemophilus infections and another against meningitis.

In children, antibiotics might be given for at least two years after the spleen is taken out and sometimes until age 21. If you are an adult and you plan to travel to remote areas or if for some other reason a doctor will not be available, you should have a supply of antibiotics with you to take at the first sign of infection. You should talk to your doctor about which antibiotics are best for you.

You should avoid the risk of malaria if you travel to tropical countries. You are now also more likely to get infections from dog bites, and to get an infection caused by Babesia, an infection transmitted by deer ticks that is common in the Cape Cod area and Nantucket Island, both in Massachusetts.