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Publication Type
Journal Article
UWI Author(s)
Author, Analytic
Wierenga, Klaas J.; Hambleton, Ian R. ; Wilson, R. M. ; Alexander, H. ; Serjeant, Beryl E.; Serjeant, Graham R.
Author Affiliation, Ana.
Tropical Medicine Research Institute
Article Title
Significance of fever in Jamaican patients with homozygous sickle cell disease
Medium Designator
n/a
Connective Phrase
n/a
Journal Title
Archives of Disease in Childhood
Translated Title
n/a
Reprint Status
n/a
Date of Publication
2001
Volume ID
84
Issue ID
2
Page(s)
156-9
Language
eng
Connective Phrase
n/a
Location/URL
n/a
ISSN
1468-2044
Notes
n/a
Abstract
Investigates the cause and outcome of high fever in Jamaican children with homozygous sickle cell disease. Conducted a retrospective review of febrile episodes in a three year period (1 September 1993 to 31 August 1996) at the Sickle cell clinic, an outpatient clinic in Kingston among patients with homozygous sickle cell disease under 17 years of age presenting with an axillary temperature >/= 39.0 degrees C (102.4 degrees F). There were 165 events in 144 patients (66 (45.8%) boys) with a median age of 6.1 years. Bacteraemia was found in 10 (6.1%) events (three Streptococcus pneumoniae, two Haemophilus influenzae type b, two Salmonella sp, one Escherichia coli, one Enterobacter sp, and one Acinetobacter sp), and urinary tract infections in four (2.4%). All cultures of cerebrospinal fluid were sterile. Acute chest syndrome occurred in 36 (21.8%) events. A painful crisis was associated with 45 (27.3%) events and was the only pathology identified in 20 events (12.1%). Hospital admission was necessary in 66 cases including all those with bacteraemia and 31 with acute chest syndrome. There were two deaths: a 5 year old boy with septic shock associated with H influenzae septicaemia, and a 3 year old boy with the acute chest syndrome. Painful crisis and acute chest syndrome were the most common complications associated with high fever, but other important associated features included bacteraemia and urinary tract infection. Enteric Gram negative organisms accounted for 50% of positive blood cultures.....
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