Fever in Sickle Cell Disease: Thinking Beyond Bacteremia

Area of Science:

• Hematology
• Pediatrics
• Immunology

Background:

• Sickle cell disease (SCD) presents complex pathophysiology and diverse symptoms.
• Fever is a common reason for emergency department visits in pediatric SCD patients.
• Immunocompromised status in SCD due to hyposplenism elevates infection risk.

Purpose of the Study:

• To present a case of prolonged fever in an adolescent with SCD.
• To explore noninfectious etiologies of fever in SCD patients.
• To emphasize the importance of considering noninfectious causes in persistent fever.

Main Methods:

• Case report of an adolescent female with SCD experiencing prolonged fever.
• Initial treatment focused on presumed infection with antibiotics.
• Subsequent investigations to identify noninfectious causes of fever.

Main Results:

• The patient presented with prolonged fever and a complicated clinical course.
• Antibiotic therapy for presumed infection was ineffective.
• Further investigations revealed noninfectious etiologies for the fever.

Conclusions:

• Fever in sickle cell disease necessitates careful evaluation for both infectious and noninfectious causes.
• Prolonged or unresponsive fever warrants a broader differential diagnosis.
• Noninfectious conditions should be considered in the management of febrile SCD patients.