UMEM Educational Pearls - By Natasha Smith

Category: Pediatrics

Title: Sickle Cell Disease and Fever

Keywords: sickle cell, HgSS, fever, sepsis (PubMed Search)

Posted: 9/3/2021 by Natasha Smith, MD
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  • Watch out for Streptococcus pneumoniae sepsis! Patients can look well for several hours, then suddenly decline, leading to shock or death.
  • Note that nearly half of patients with HgSS will have diminished spleen function by 1 year of age
  • Start antibiotics early, even if patients are immunized or are taking prophylactic penicillin
  • Antibiotic recommendations: long-acting cephalosporin +/- Vancomycin 
  • Order CBC, reticulocyte count, blood culture, CXR, and other testing as needed based on presentation
  • Admit patients with high fever, toxic appearance, infiltrate on CXR, hypoxia, tachypnea not explained by fever, poor intake/dehydration, severely abnormal CBC, history of S. pneumoniae sepsis, pain crisis + fever

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