Fever in young patients with sickle cell disease in southwest region of Saudi Arabia

ABSTRACT

The aim of the study was to determine the magnitude of the problem of infection in patients with sickle cell disease. A total of 269 admissions of 94 patients with sickle cell disease, aged 3 months to 20 years, were reviewed. Frequency of fever in the absence of obvious infection, and profile of infection with temperature over 38.5C were noted. Patients with sickle cell / thalassaemia or other combinations and those given pneumococcal vaccinations or prophylactic antibiotics were excluded. Two hundred and seven admissions were due to crises and 62 admissions were due to fever. Of the crises, 111[53.6%] were associated with fever, 79 of whom had no focus of infection [38.2%]. Of the 173 admissions with fever, the temperature was over 38.5°C in 96 and the profile of infections was as follows upper respiratory infection 18.8%, pneumonia 10.4% septicemia 6.3%, osteomyelitis 5.2%, urinary infection 4.2%, gastroenteritis 3.1%, malaria 1%, septic arthritis 1%, lymphadenitis 1%, no focus 49%. Septicemia was caused by Salmonella on three occasions [one death], Streptococcus pneumoniae [death], Staphylococcus aureus and Streptococcus viridans in the remaining three. Infection with Streptococus pneumoniae was not common in our patients