title: Incidence of serious bacterial infections in febrile children with sickle cell disease.
abstract: OBJECTIVE
  To determine the incidence of serious bacterial infections in febrile children with sickle cell disease and to describe the outcomes of children discharged from the pediatric emergency department.
  
  
  METHODS
  We conducted a retrospective chart review of 188 febrile patients with sickle cell disease presenting to our pediatric emergency department over a 10-year period. Serious bacterial infection was defined as bacteremia, meningitis, urinary tract infection, osteomyelitis, or pneumonia.
  
  
  RESULTS
  Our overall incidence rate for serious bacterial infections was 16.0% (95% confidence interval [CI] = 10.8% to 21.2%). Pneumonia had the highest incidence rate of 13.8% (95% CI = 8.8% to 18.8%). This was followed by bacteremia and urinary tract infections, both with incidence rates of 1.1% (95% CI = 0.0% to 2.5%). We had no cases of meningitis or osteomyelitis in our study group.
  
  
  CONCLUSIONS
  We had an incidence of 16.0% for serious bacterial infections in febrile children with sickle cell disease, with the majority of patients diagnosed with pneumonia.
authors: Loma Linda University, Loma Linda, CA 92354, USA. nbansil@llu.edu
authors: Nelson H
authors: NH
authors: Bansil
authors: Tommy Y
authors: TY
authors: Kim
authors: Linh
authors: L
authors: Tieu
authors: Besh
authors: B
authors: Barcega
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications*; D016470:Bacteremia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D005260:Female; D005334:Fever / Q000209:etiology*; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D013290:Streptococcal Infections / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D034363:Viridans Streptococci / Q000302:isolation & purification
keywords: febrile children; pediatric emergency department; serious bacterial infection; sickle cell disease