Powars D, Overturf G, Turner E
Pediatrics. 1983 Jun;71(6):927-31.
The risk of Haemophilus influenzae septicemia/meningitis to children who have sickle cell anemia (SS) has been determined to be greater than that seen among normal infants. Of ten bacteriologically proven cases, eight episodes of infection were observed among 234 children with sickle cell anemia (645 person-years), who were less than 5 years of age. There was one case per 69 infants with sickle cell anemia who were less than 18 months old and one case per 36 children with sickle cell anemia between 19 and 59 months of age. Unexpectedly, two infections occurred among 224 children (824 person-years), aged 5 to 9 years; both died. Contrary to the rapid clinical course of pneumococcal infections in children with sickle cell anemia H influenzae septicemia was regularly heralded by a greater than 24-hour prodrome of upper respiratory tract infection, low-grade fever, and otitis media. Three (30%) preventable deaths occurred. Antibiotic therapy for the febrile child with sickle cell anemia must be predicated on the known 400-fold increased risk of pneumococcal septicemia in those less than 5 years old and the fourfold risk of H influenzae septicemia in those less than 9 years of age.
已确定镰状细胞贫血（SS）患儿患流感嗜血杆菌败血症/脑膜炎的风险高于正常婴儿。在234名5岁以下的镰状细胞贫血患儿（645人年）中，观察到8例感染，其中10例经细菌学证实。18个月以下的镰状细胞贫血婴儿中每69例有1例感染，19至59个月的镰状细胞贫血儿童中每36例有1例感染。出乎意料的是，在224名5至9岁的儿童（824人年）中发生了2例感染；两人均死亡。与镰状细胞贫血患儿肺炎球菌感染的快速临床病程相反，流感嗜血杆菌败血症通常在出现上呼吸道感染、低热和中耳炎超过24小时的前驱症状后发生。发生了3例（30%）可预防的死亡。对于发热的镰状细胞贫血患儿，抗生素治疗必须基于已知的5岁以下儿童肺炎球菌败血症风险增加400倍以及9岁以下儿童流感嗜血杆菌败血症风险增加4倍的情况。
