Death for sepsis following dental procedures in an asplenic patient. Case report and medico-legal considerations

The spleen is crucial in regulating immune homeostasis through its ability to link innate and adaptive immunity and in protecting against infections. Asplenic or hyposplenic individuals are especially vulnerable to invasive infections caused by encapsulated bacteria. Such infections have often a sudden onset and fulminant course. Infectious diseases incidence in asplenic subjects can be reduced by preventive measures such as vaccinal immunization and antibiotic prophylaxis directed to the patients and their families. The aim of our paper is to report a case of a dentist who was claimed in a criminal proceeding following the death for sepsis of an asplenic patient after dental implantological procedures. Moreover the study analyzes the literature about the possible presence in the oral cavity of the pathogens responsible for the Overwhelming Post Splenectomy Infection syndrome (OPSI) in the asplenic patient, the suggested approach, such as prophylaxis, information, prompt therapeutic intervention and what was the medico-legal analysis of the case in a criminal context.