Halwani Manal A
Pediatric Emergency, King Abdulaziz University Hospital, Jeddah, SAU.
Cureus. 2023 Sep 9;15(9):e44959. doi: 10.7759/cureus.44959. eCollection 2023 Sep.
Background Children with sickle cell disease (SCD) are prone to bacterial infections, culminating in life-threatening incidences. Early evaluation of children with SCD helps in effective management and support. Methodology A retrospective study was conducted using medical records for febrile episodes in SCD children ≤14 years of age who presented to the Emergency Department of King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia from 2015 to 2018. A total of 304 episodes were encountered in the Emergency Department during this period. Results The clinical diagnosis included confirmed bacterial infection (4.5%), presumed bacterial infection (24.6%), and those without bacterial infection (57.5%). The incidence of bacteremia was found in 3.0% of the episodes and urinary tract infection in 1.5%. The most common isolates were , , species, and . Overall, 52% of the febrile episodes resulted in hospitalization, of which 74% had at least one prior hospitalization. The hospitalization probability across the two sexes was statistically insignificant (p = 0.029). The likelihood of admission increased with age (p < 0.001) and temperature (p < 0.001). The study included 140 children with SCD who had at least one abdominal sonogram performed at our hospital between 2015 and 2018. There were changes in the radiographic appearance of the spleen in patients with SCD who were expected to undergo autosplenectomy between the ages of five and 17 years. Conclusions The study envisages the risk associated with febrile episodes and the prompt recovery of such patients through clinical confirmations. Parents should be aware and observant of the complications of infectious illnesses for speedy medical assistance.
镰状细胞病(SCD)患儿易发生细菌感染,最终可能导致危及生命的情况。对SCD患儿进行早期评估有助于有效管理和支持。
采用回顾性研究,利用2015年至2018年期间在沙特阿拉伯王国吉达阿卜杜勒阿齐兹国王大学医院急诊科就诊的14岁及以下SCD患儿发热发作的病历。在此期间,急诊科共遇到304次发作。
临床诊断包括确诊细菌感染(4.5%)、疑似细菌感染(24.6%)和无细菌感染(57.5%)。在3.0%的发作中发现菌血症,1.5%的发作中发现尿路感染。最常见的分离菌是 、 、 种和 。总体而言,52%的发热发作导致住院,其中74%至少有一次先前住院史。两性之间的住院概率在统计学上无显著差异(p = 0.029)。入院可能性随年龄(p < 0.001)和体温(p < 0.001)增加。该研究纳入了140名SCD患儿,他们在2015年至2018年期间在我院至少进行了一次腹部超声检查。预计在5至17岁之间进行自体脾切除的SCD患者脾脏的影像学表现有变化。
该研究设想了发热发作相关的风险以及通过临床确诊促使此类患者迅速康复。家长应了解并注意感染性疾病的并发症,以便迅速获得医疗帮助。