ABSTRACT
One-hundred-and-fifty-two severely anaemic patients, aged 6 months to 14 years were studied with a view to ascertaining the incidence of bacteraemia in them. Haemoglobin genotype AA was seen in 68 (45 per cent) of the patients, 38 (25 per cent) patients were of haemoglobin genotype SS; 35 (23 per cent) patients were of haemoglobin genotype AS; three (2 per cent) patients were of haemoglobin genotype AC and eight (5 per cent) patients were of haemoglobin genotype SC. Positive blood cultures were obtained in a total of 15 (10 per cent) patients. Of these 15 patients, 10 (22 per cent) patients were sicklers (9 HbSS; 1 HbSC) of a total of 46 sicklers studied. The remaining five (5 per cent) patients that had positive blood cultures were non-sicklers out of a total of 106 non-sicklers studied. There was a statistically significant difference between the sicklers and non-sicklers who had positive blood cultures (P < 0.05). The presence or absence of positive blood culture did not correlate with the severity of anaemia in either the sicklers or the non-sicklers. It is suggested that any severe anaemic patient with clinical features suggestive of sickle cell anaemia must have a blood culture done in the course of management. An 'identify at all costs' approach should not apply to severe anaemic children who are non-sicklers. The yield is low and cost high, clinicians should be selective in deciding in which patients blood cultures are warranted.
