Hematologic alterations during acute infection in children with sickle cell disease

In order to assess the hematologic features of acute bacterial infection in sickle cell anemia, we compared complete blood counts of 23 affected children with proven bacterial infection (Group A) to those of 22 patients with fever but without evidence of bacterial disease (Group B). Univariate and multivariate analyses of the data were carried out. Values for hemoglobin and platelet count were similar in Group A and Group B patients even though these measurements in both groups differed from base line steady state values. Absolute band counts were usually greater in Group A patients, but the sensitivity and specificity of elevated band counts as a diagnostic tool for bacterial infection were relatively low. We conclude that no aspect of the complete blood count can be used to guide major management decisions in febrile children with sickle cell anemia and potentially life-threatening infection.