Does an asplenic patient with fever in the context of an obvious viral syndrome require emergent evaluation for blood cultures and empiric IV antibiotics or can this be deferred for persistent high fever or other more concerning clinical signs or symptoms?

Yes, an asplenic patient with fever requires emergent evaluation and antibiotics no matter what. Symptoms of viral infection do not exclude bacteremia, which is your main concern and may progress quickly in the absence of a functional spleen. And yes, by doing this, many patients will receive antibi...

I do not think that asplenia alone should be the criterion for starting antibiotics and obtaining blood cultures in a febrile patient with viral syndrome. Most asplenic patients will be vaccinated against encapsulated bacteria - Streptococcus pneumoniae, H. influenzae, and Meningococcus. Even if the...