In a splenectomized patient there is increase of infection by all the following organism except
a. OPSI is among the more devastating sequelae of asplenia and is the most common fatal late complication of splenectomy.
b. Hyposplenism in the neonatal period has been suggested to contribute to the poor outcomes from neonatal sepsis.
c. S. pneumoniae is the most frequently involved organism in OPSI and is estimated to be responsible for between 50% and 90% of cases.
d. Other organisms involved in OPSI include Haemophilus influenzae, Neisseria meningitidis, Streptococcus species and other pneumococcal species, Salmonella species, and Capnocytophaga canimorsus.
e. OPSI typically begins with a prodromal phase characterized by fever and chills and nonspecific symptoms, including sore throat, malaise, myalgias, diarrhea, and vomiting.
f. Patients may have had rigors for 1 to 2 days before seeking appropriate medical treatment. Pneumonia and meningitis may be present, but many cases have no identifiable focal site of infection and present with high-grade primary bacteremia.
g. Progression of the illness is classically rapid, with the development of hypotension, disseminated intravascular coagulation, respiratory distress, coma, and death within hours of presentation.
h. The mortality rate is between 50% and 70% for fully developed OPSI despite antibiotics and intensive care.