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Splenectomy for immune thrombocytopenia (ITP) can increase the number of platelets. However, patients without functioning spleen become vulnerable to bacteria. Overwhelming post-splenectomy infection( OPSI), its most fulminant form, is rapidly progressive and is highly fatal. A 76-year-old male, who had undergone splenectomy for refractory ITP and taken a vaccination for treptococcus pneumoniae 4 years previously, was admitted to undergo cardiac surgery for severe aortic regurgitation and coronary disease. Prior to operation, high dose in