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Management of the febrile patient with sickle cell disease

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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 (1)

Reference:

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