Fever in children with sickle cell hemoglobinopathies
E. Kravis, G. Fleisher and S. Ludwig
To estimate the frequency of bacteremia in children with sickle cell
hemoglobinopathies (SCHs) and to evaluate the usefulness of various
findings in predicting septicemia, we reviewed the charts of 153 patients
with SCH who made 326 emergency department visits in a one-year period.
Ninety children were febrile (greater than 38.0 degrees C). Four children,
three of whom were 2 years old or younger, were bacteremic with
Streptococcus pneumoniae. A temperature greater than 40 degrees C occurred
in three of the four and was more common than in those who had sterile
blood cultures. Two of the five patients who were 2 years old or younger
and who had the combination of a WBC count of 20,000/cu mm or more and a
temperature of 39.5 degrees C or higher were bacteremic. These children
were significantly more likely to have bacteremia than those with lower
temperatures and WBC counts.
