Vaccinations For Age 9 To 99

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Table 3: Recommended Vaccinations [82].

Vaccination after splemectomy or in
pneumococcal Meningococcal PC influence Seasonal flu
hyposplenic status
1 dose PCV13 and 1 dose
of PPSV23 after at least 8
Vaccination in adults and children >24 weeks. 1 dose of Meningococcal ACWY
months (Unless they have already been Some authors conjugated vaccine.
1 dose 1 dose annually
fully vaccinated earlier in life for the recommended a second A series of 2 doses of Meningococcal
bacteria considered) PPSV23 dose. B vaccine at least 1 month apart.
After 5 years from the first
one.
An age-adapted PCV13
full cycle of immunization
Vaccination for children less than 24
starting from 6 weeks of
months of age. Unless already vaccinated An age-adapted full cycle of Annually (minimum age 6
life.
for the bacteria considered (in those immunization with Meningococcal B An age-adapted, full cycle months) 2 doses divided by
1 dose of PPSV 23
subjects antibiotic prophylaxis is and Meningococcal C (conjugated) of immunization with at least 4 weeks in children
(minimum age 2 years) at
recommended for at least 1 year after vaccine if younger than 12 months Haemophilus type B- aged 6 months through 8
least 8 weeks after the last
splenectomy and/or until the 3rd birthday or Meningococcal ACWY conjugated conjugated vaccine. years 1 dose for children 9
PCV 13.
whichever comes last) vaccine in > 12 months. years and older.
PPSV 23 should be
readministered only once. 3
years after the first dose.
Lifelong prophylactic antibodies should be offered to patients considered at continued high risk; aged less than
6 years or greater than 50 years, or
1) Having inadequate serological response to pnemococcal vaccination, or
2) With a history of previous invasive pneumococcal disease, or
3) Splenectomized for underlying haematological malignancy particularly in the context of on-going
Antibiotic prophylaxis after splenectomy or immunosuppression
hyposphenic status Suggested regimens:
Birth to 3rd month AMX/CLA or AMX 10 mg/kgBID
3rd month-5 years AMX 10 mg/kg BID
>5 years and adults AMX 250 mg BID
For pencillin allergic patients, probably TMP/SMX is the best option, but this should be discussed case by-case. According also
to the type of allergy in cause.
PCV13 is a Indocavalent conjugated pneumococcal and PPSV23 is a 23-valent polyvaccinide pnemoniccal vaccine. AMX Amoxicillin.
AMX XLA Amoxiccillin clavalanic, TMP SMX cotrimonozole
Table 4: WSES Class / Risk [84].

key, also to avoid serious psychological imbalances that can
ɸ WSES class AAST Haemodynamic promote episodes or suicidal thoughts [133].
Minor WSES I I-II Stable
Conclusions
Moderate WSES II III Stable
Severe WSES III IV-V Stable Therefore, it is possible to conclude the following:
WSES IV I-V Unstable
1) patients presenting with hemodynamic instability and/
or peritonitis should be referred for urgent surgical
[91,92] and depression [93] or other kinds [94-96], concerning intervention;
the near future that awaits the patient and his new quality
2) non-operative treatment of splenic lesions is now
of life; but such destabilization may hyperactivate certain
the treatment modality of choice in hemodynamically
personality traits [97-104] decompensating the patient already
stable patients, regardless of the grade of the lesion;
suffering from psychopathological disturbances [105-107] or
prior neurologically based conditions or with traumatic brain 3) the method of Non-Operative Management of splenic
comorbidity [108-120] or prone to easily altered perception trauma is confirmed as a method characterized by lower
(as in psychotic states or psychotic tendencies) [121,122], morbidity, mortality and hospitalization compared to
especially if associated with the traumatic condition there is the surgical method;
a neoplastic origin or comorbidity [123], and therefore having
4) low morbidity and overall mortality is achieved when
to resort to psychotherapeutic or psychiatric intervention
the NOM procedure is applied to an appropriate patient
[124,125] to restore the lost conditions of well-being [126-
population;
129]. Another profile of extreme clinical interest, also because
of the numerous correlations with psychological disorders, 5) nonoperative management of splenic lesions should
is intestinal dysbiosis [130-132] caused by prescribed drug only be considered in a setting that offers the possibility
therapy, which in turn can negatively affect the balance of of serious clinical monitoring and evaluations and that
intestinal flora and all its functions. These profiles, therefore, has an operating room available for 24-hour urgent
deserve greater attention and dignity, especially in a holistic laparotomies;
031
Citation: Perrotta G, Guerrieri E, Guerrieri M (2021) Splenic trauma: Definition, classifications, clinical profiles and best treatments. Open J Trauma 5(1): 019-036.
DOI: https://dx.doi.org/10.17352/ojt.000038

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Table 3: Recommended Vaccinations [82].

Table 4: WSES Class / Risk [84].

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