title: Outpatient Management of Febrile Children With Sickle Cell Disease.
abstract: The electronic medical records at 2 children's hospitals were reviewed from June 1, 2011 to May 31, 2013 for all patients with sickle cell disease who presented with fever. Of a total of 390 blood cultures drawn, 11 cultures (2.8%) turned positive with only 1 (0.3%) growing a true pathogen. This culture turned positive in 13 hours. There were 154 patients who received exclusive outpatient management of fever. Fourteen patients (9.1%) completed 1 acute care visit, 16 patients (10.4%) completed 2 acute care visits, and 124 patients (80.5%) completed 3 acute care visits. Of those treated exclusively as outpatients, there was 1 positive culture that was considered a contaminant. Although the overall rate of positivity was low, this study confirms previous findings that pediatric blood cultures become positive with pathogens within 48 hours. Given the high rate of compliance and early time to positivity of true pathogens, we suggest that follow-up for the febrile sickle cell disease patients can be treated on an outpatient basis.
authors.affiliation: University of Chicago, Chicago, IL, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Sokol
authors.affiliation: University of Chicago, Chicago, IL, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Obringer
authors.affiliation: University of Chicago, Chicago, IL, USA.
authors.forename: Brett
authors.initials: B
authors.lastname: Palama
authors.affiliation: University of Chicago, Chicago, IL, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Hageman
authors.affiliation: University of Chicago, Chicago, IL, USA rpeddint@peds.bsd.uchicago.edu.
authors.forename: Radhika
authors.initials: R
authors.lastname: Peddinti
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care; D000755:Anemia, Sickle Cell / Q000150:complications*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001769:Blood / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology; D006801:Humans; D007223:Infant; D008297:Male; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: antibiotics; fever; sickle cell disease