Pediatric vasoocclusive crisis and weather conditions.

BACKGROUND: Previous studies have demonstrated associations of frequency of vasoocclusive crisis with weather conditions in adults, although relationships have been inconsistent. OBJECTIVES: Our objective was to determine if there is an association between weather conditions and pediatric emergency department (ED) visits, hospital admissions, and day and severity of pain precipitation for vasoocclusive crisis (VOC). METHODS: A retrospective observational study was performed at a large tertiary care pediatric center. We reviewed health records of all VOC patients under the age of 18 years with a chief complaint of pain and performed correlations between daily and average weekly and monthly weather conditions and frequency of painful crises. RESULTS: A total of 430 visits for VOC to the ED were documented from January 2005 to December 2006. Significant correlations were noted between the daily and weekly number of painful crises and colder temperatures (ρ=-0.11, p=0.004 for daily data and r=0.25, p=0.01 weekly) and wind speed (ρ=0.13, p<0.001 and r=0.25, p=0.01). The monthly number of painful crises was moderately correlated with temperatures (r=-0.42, p=0.04). The average monthly pain score was higher in more humid months (r=0.44, p=0.03). CONCLUSION: We found significant correlations of VOC with weather conditions where colder temperatures and higher wind speed were associated with a higher incidence of VOC in children. Health care providers as well as parents should be aware of these findings and ensure that preventive measures are instituted in patients at risk.

Bacterial blood cultures in children with sickle cell disease.

BACKGROUND: Children with sickle cell disease (SCD) are considered at risk for bacteremia, especially when they present to the emergency department (ED) with fever. OBJECTIVE: We aimed to determine the incidence of bacteremia in children with SCD presenting with or without fever to a pediatric ED. METHODS: A retrospective chart review of 692 pediatric ED visits of children with SCD during a 2-year period was conducted. RESULTS: Seven blood cultures (6 homozygous and 1 heterozygous) had bacterial growth (1.3%; 95% confidence interval, 0.5-2.1), 3 of which were among febrile children (1.7%; 95% confidence interval, 0-3.6). All identified microorganisms are part of the normal skin or oral flora and could represent contamination. None of the patients had growth of the Streptococcus pneumoniae species. CONCLUSION: A very low rate of bacterial growth and no S pneumoniae were found. The absence of S pneumoniae in our cohort can be associated with the addition of the 7-valent pneumococcal conjugate vaccine.