We use a thermometer to ascertain the fever magnitude.

FEVER IN SICKLE CELL DISEASE: Recommendations for management

Fever is one of the most common symptoms that people with SCD report.

People living with sickle cell disease, in particular, sickle cell anaemia have a staggeringly high risk to severe bacterial infection. It is due to a reduced or often absent splenic function.

Impairment of the spleen begins as early as 2-3months old in a few infants to coincide with the period when their fetal haemoglobin starts declining. It leads to an increased risk of meningitis and septicemia, and the most offending pathogen being Streptococcus pneumoniae.

It is worth noting that before the advent of pneumococcal vaccination and penicillin prophylaxis, severe pneumonia had been nearly, always fatal.

Any febrile illness in a person with sickle cell disease should be considered an emergency for two reasons. First is the uncertainty of complete immunization, secondly, the possibility of penicillin-resistant organisms.

Because a fever is a rather unspecific symptom, even among patients living with sickle cell disease, the panel of experts derived the following recommendations in regards to the management of fever in sickle cell disease.

  • Immediately evaluate with history and physical examination, complete blood count with differential, reticulocyte count, blood culture, and urine culture when appropriate, in any person with SCD who presents with a temperature ≥38.5°C (101.3°F).
  •  For children with SCD and a temperature ≥38.5°C (101.3°F), administer empiric parenteral antibiotics in accord with the national clinical guidelines. They should provide coverage against Streptococcus pneumoniae and gram-negative enteric organisms. In those that do not appear to be ill, outpatient management with an oral antibiotic is an acceptable approach.
  • Hospitalize people with SCD and a temperature ≥39.5°C (103.1°F) and who appear ill for close observation and intravenous antibiotic therapy.
  • In people with SCD whose febrile illness is accompanied by shortness of breath, tachypnea, cough, with or without rales, obtain an immediate x-ray to investigate for acute chest syndrome and manage accordingly.
  • Lastly, include bacterial osteomyelitis as a differential, in febrile people with SCD who have localized or multifocal bone tenderness: manage accordingly.

Don’t forget to share this article, and don’t forget to check out the next article about recommendations for the management of acute renal failure. Remember that you can gain full access to these recommendations from the National Heart, Lung, and Blood Institute.

 

Leave a Reply

Your email address will not be published. Required fields are marked *

Related Posts

An african child with mumps seated on a chair. Created by Bing Image creator

Mumps virus infection in adolescent males may cause infertility! Why?

Abstract When someone talks about the Mumps virus, we all remember that time when the cheeks of the neighborhood playmates became painfully puffed up like puffy fish – following an inflammatory response that culminated in the swelling of the parotid glands – Mumps parotitis. However, one of the distinctive features of mumps infection is its ...

Read More
Infant nutrition: An African boy taking porridge.

Nourishing Start: The Importance of Infant Nutrition

Introduction: Proper nutrition during infancy is crucial for babies’ healthy growth and development. This article aims to provide an understanding of infant nutrition, highlighting the importance of breastfeeding, introducing solid foods, and promoting a balanced diet for optimal health outcomes. Breastfeeding: Nature’s Perfect Food Breast milk is considered the gold standard for infant nutrition. It ...

Read More
Epilepsy is a neurological disorder that affects people of all ages. It is characterized by recurrent seizures, which are sudden, uncontrolled electrical disturbances in the brain.

Epilepsy: Understanding Seizures and Living with the Condition

Introduction: Epilepsy is a neurological disorder that affects people of all ages. It is characterized by recurrent seizures, which are sudden, uncontrolled electrical disturbances in the brain. In this essay, we will explore epilepsy, its causes, symptoms, and available treatments, as well as the importance of raising awareness and supporting individuals living with this condition. ...

Read More
Enable Notifications OK No thanks