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December 1982, Vol 136, No. 12 >
Article | December 1982

Fever in Children With Sickle Cell Hemoglobinopathies FREE

Stephen Ludwig, MD; Gary Fleisher, MD; Ellen Kravis, MD
[+] Author Affiliations

Read before the University Association for Emergency Medicine, San Antonio, Tex, April 14, 1981.

Reprint requests to The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104 (Dr Fleisher).


Arch Pediatr Adolesc Med. 1982;136(12):1075-1078. doi:10.1001/archpedi.1982.03970480041010
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• 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 (>38.0 °C). Four children, three of whom were 2 years old or younger, were bacteremic with Streptococcus pneumoniae. A temperature greater than 40 °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 °C or higher were bacteremic. These children were significantly more likely to have bacteremia than those with lower temperatures and WBC counts.

(Am J Dis Child 1982;136:1075-1078)

REFERENCES

1 +
Barrett-Connor E:  Bacterial infection and sickle cell anemia . Medicine 1971;;50:96-112.
2 +
Pearson HA:  Sickle cell anemia and severe infections due to encapsulated bacteria . J Infect Dis 1977;;136:S25-S30.
3 +
Overturf GD, Powers D, Baraff LJ:  Bacterial meningitis and septicemia in sickle cell disease . Am J Dis Child 1977;;131:784-787.
4 +
Winkelstein JA, Drachman RH:  Deficiency of pneumococcal serum opsonizing activity in sickle cell disease . N Engl J Med 1968;;279:459-466.
5 +
Pearson HA, Spencer RP, Cornelius EA:  Functional asplenia in sickle cell anemia . N Engl J Med 1969;;281:923-925.
6 +
Johnstone RB, Newman SL, Struth AG:  An abnormality of the alternate pathway of complement activation in sickle cell disease . N Engl J Med 1973;;288:803-808.
7 +
Bjornson AB, Gaston MH, Zellner CL:  Decreased opsonization for Streptococcus pneumoniae in sickle cell disease: Studies on selected complement components and immunoglobulins . J Pediatr 1977;;91:371-378.
8 +
Rogers DW, Vaidy S, Sergeant GR:  Early splenomegaly in homozygous sickle cell disease: An indicator of susceptibility to infection . Lancet 1978;;2:963-965.
9 +
McGowan JE, Bratton L, Klein JO, et al:  Bacteremia in febrile children seen in a 'walk-in' pediatric clinic . N Engl J Med 1973;;288:1309-1312.
10 +
Teele DW, Pelton SI, Grant MJA, et al:  Bacteremia in febrile children under 2 years of age: Results of cultures of blood of 600 consecutive febrile children seen in a 'walk-in' clinic . J Pediatr 1975;;87:277-230.
11 +
McCarthy P, Grundy GW, Spiesel SZ, et al:  Bacteremia in children: An outpatient clinical review . Pediatrics 1976;;57:861-868.
12 +
McCarthy PL, Jekel JF, Stashwick CA, et al:  History and observation variables in assessing febrile children . Pediatrics 1980;;65:1090-1095.
13 +
Bratton L, Teele DW, Klein JO:  Outcome of unsuspected pneumococcemia in children not initially admitted to the hospital . J Pediatr 1977;;90:703-706.
14 +
McIntosh S, Rooks Y, Ritchey AK, et al:  Fever in young children with sickle cell disease . J Pediatr 1980;;96:199-204.
15 +
Lobel JS:  Fever with sickle cell disease . J Pediatr 1980;;97:1038-1039.
16 +
Henretig FH, Goldstein R, Torry S, et al: Clinical assessment of febrile infants at risk for occult bacteremia, abstract. McLean, Va, Ambulatory Pediatric Association, 1981, p 106.

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1 +
Barrett-Connor E:  Bacterial infection and sickle cell anemia . Medicine 1971;;50:96-112.
2 +
Pearson HA:  Sickle cell anemia and severe infections due to encapsulated bacteria . J Infect Dis 1977;;136:S25-S30.
3 +
Overturf GD, Powers D, Baraff LJ:  Bacterial meningitis and septicemia in sickle cell disease . Am J Dis Child 1977;;131:784-787.
4 +
Winkelstein JA, Drachman RH:  Deficiency of pneumococcal serum opsonizing activity in sickle cell disease . N Engl J Med 1968;;279:459-466.
5 +
Pearson HA, Spencer RP, Cornelius EA:  Functional asplenia in sickle cell anemia . N Engl J Med 1969;;281:923-925.
6 +
Johnstone RB, Newman SL, Struth AG:  An abnormality of the alternate pathway of complement activation in sickle cell disease . N Engl J Med 1973;;288:803-808.
7 +
Bjornson AB, Gaston MH, Zellner CL:  Decreased opsonization for Streptococcus pneumoniae in sickle cell disease: Studies on selected complement components and immunoglobulins . J Pediatr 1977;;91:371-378.
8 +
Rogers DW, Vaidy S, Sergeant GR:  Early splenomegaly in homozygous sickle cell disease: An indicator of susceptibility to infection . Lancet 1978;;2:963-965.
9 +
McGowan JE, Bratton L, Klein JO, et al:  Bacteremia in febrile children seen in a 'walk-in' pediatric clinic . N Engl J Med 1973;;288:1309-1312.
10 +
Teele DW, Pelton SI, Grant MJA, et al:  Bacteremia in febrile children under 2 years of age: Results of cultures of blood of 600 consecutive febrile children seen in a 'walk-in' clinic . J Pediatr 1975;;87:277-230.
11 +
McCarthy P, Grundy GW, Spiesel SZ, et al:  Bacteremia in children: An outpatient clinical review . Pediatrics 1976;;57:861-868.
12 +
McCarthy PL, Jekel JF, Stashwick CA, et al:  History and observation variables in assessing febrile children . Pediatrics 1980;;65:1090-1095.
13 +
Bratton L, Teele DW, Klein JO:  Outcome of unsuspected pneumococcemia in children not initially admitted to the hospital . J Pediatr 1977;;90:703-706.
14 +
McIntosh S, Rooks Y, Ritchey AK, et al:  Fever in young children with sickle cell disease . J Pediatr 1980;;96:199-204.
15 +
Lobel JS:  Fever with sickle cell disease . J Pediatr 1980;;97:1038-1039.
16 +
Henretig FH, Goldstein R, Torry S, et al: Clinical assessment of febrile infants at risk for occult bacteremia, abstract. McLean, Va, Ambulatory Pediatric Association, 1981, p 106.

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