ED Pathway for Evaluation/Treatment of Children with Sickle Cell Disease with Fever

Rationale

Over the last decade, the institution of PCN prophylaxis and use of pneumococcal vaccine has reduced the risk of bacteremia in patients with SCD. Over the last 18 months, out of approximately 900 febrile episodes, 5 patient’s had a blood culture that was positive, 3/5 were contaminants. The other 2 patients did well. Thus in low risk patients, treatment, discharge and close follow-up has the advantage of decreasing hospitalization and improving the quality of life of kids with SCD.