Management of the febrile patient with sickle cell disease
Low grade pyrexia (<38 C) is frequently seen in uncomplicated painful crises and this does not necessarily indicate an infection (unless infection is suspected for other reasons) (1).
- these patients need not receive broad spectrum antibiotics
- routine penicillin V (or an alternative in penicillin allergic patients) should be continued
Patients with temperatures of more than 38 C should be evaluated immediately since life threatening complications are more common in these populations due to hyposplenism:
- clinical examination, blood count, blood/urine/other cultures (according to clinical features) and chest x ray should be mandatory
- start empirical antibiotics immediately after taking culture samples (1)
During assessment special consideration should be given to the following common causes of high fever in SCD:
- Pneumococcal sepsis
- gram negative sepsis
- lower respiratory tract infection
- urinary tract infection
- osteomyelitis
Reference
- Brousse V, Makani J, Rees DC; Management of sickle cell disease in the community. BMJ. 2014 Mar 10;348:g1765.
Create an account to add page annotations
Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.