Septicemia due to ESBL producing klebsiella pneumoniae in multi transfused thalassemic patient with splenectomy.

The spleen plays a major role in the opsonisation of capsulated bacteria. A thalassemic patient is treated with prophylactic antibiotics, vaccines, chelating agents, blood transfusions and many a time, with splenectomy. The surgery predisposes patients to infections with capsulated organisms.Vaccines can prevent occurrence of streptococcal and haemophilus infections to some extent. However Gram negative septicaemia due to capsulated bacteria can be overwhelming in these patients and when caused by multidrug resistant strains can warrant the need for administration of expensive antibiotics to save the life of the patient.