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Fatal pneumococcal septicaemia associated with asplenia and isomerism of the right atrial appendages.
  1. I A Murdoch,
  2. R D Anjos,
  3. A Mitchell
  1. Department of Paediatric Cardiology, Guy's Hospital, London.


    A 22 month old male infant with isomerism of the right atrial appendages (associated with a complete atrioventricular septal defect, double outlet right ventricle, and pulmonary valve stenosis) died from pneumococcal septicaemia after a 36 hour illness. He had not been given penicillin prophylaxis. Asplenia was confirmed at necropsy. In a survey of 50 paediatric cardiologists in the United Kingdom, 13 (33%) of the 40 (80%) who replied did not advise any prophylactic measures against pneumococcal infection in patients with isomerism of the right atrial appendages.

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