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[Fulminating pneumococcal septicemia in a 2 year old child with sickle cell anemia]
M Visser1, P H G Hogeman, A J van Vught
1Universitair Medisch Centrum, Wilhelmina Kinderziekenhuis, afd. Algemene Kindergeneeskunde, Postbus 85.090, 3508 AB Utrecht.
Insights
A young boy with sickle cell anemia died from a pneumococcal infection. Children with this condition are highly susceptible to such infections, necessitating vaccinations and antibiotic prophylaxis.
Area of Science:
- Pediatrics
- Hematology
- Infectious Diseases
Background:
- Homozygous sickle cell anemia (HbSS) significantly impairs spleen function in early childhood.
- Impaired spleen function increases susceptibility to severe invasive infections, particularly from encapsulated bacteria.
Observation:
- A 2-year-old boy with HbSS died from pneumococcal septicemia despite intensive care.
- This case highlights the acute risks faced by young children with HbSS.
Findings:
- Children with HbSS experience spleen dysfunction due to hemolysis and vaso-occlusive episodes.
- This dysfunction leads to a heightened risk of life-threatening infections from encapsulated bacteria like Streptococcus pneumoniae.
Implications:
- Routine pneumococcal vaccination at 2 years, with re-vaccination every 3-5 years, is crucial.
- Antibiotic prophylaxis until age 5, and as needed thereafter, is recommended for children with HbSS.
- Early and consistent preventive measures are vital for reducing mortality in pediatric sickle cell anemia patients.
Abstract:
A 2-year-old boy known with homozygous sickle cell anaemia became acutely ill at home. Despite intensive care, he died a few hours later due to pneumococcal septicaemia. In young children with homozygous sickle cell anaemia, spleen function is already severely impaired in childhood due to haemolysis and frequent vaso-occlusive episodes. These children therefore have an elevated susceptibility to severe invasive infections with encapsulated bacteria. Vaccination against pneumococci at-2 years of age, re-vaccination every 3-5 years, and antibiotic prophylaxis until 5 years of age, and thereafter with possible infections, are therefore necessary.