sickle cell fever----work up till what age??

[unchartedem]

---

Members don't see this ad.

Hello all. I'm from EM and was curious as to what you would do if you had a sickle cell pt. w/ fever. Until what age would you do a sepsis work-up and empirically treat w/ Abx. All the way till 18 yrs?? or would you stop at age 5 since Ive read that most sepsis in sicklers occurs in kids younger than 5.

 

[elr1983]

Hello all. I'm from EM and was curious as to what you would do if you had a sickle cell pt. w/ fever. Until what age would you do a sepsis work-up and empirically treat w/ Abx. All the way till 18 yrs?? or would you stop at age 5 since Ive read that most sepsis in sicklers occurs in kids younger than 5.

We do a CBC, retic, and blood culture and treat with ceftriaxone at a minimum for every sickle cell patient with fever. In the kids less than 2, we always get a CXR, often do a UA if no source. We get a CXR about half the time in older kids. All our fever patients get admitted.

 

[Stitch]

We do a CBC, retic, and blood culture and treat with ceftriaxone at a minimum for every sickle cell patient with fever. In the kids less than 2, we always get a CXR, often do a UA if no source.

Agree. Kids under one I have a hard time sending home. Older than that you need to be in touch with their hematologist and ensure close follow up within 24 hours. We also watch them after giving ceftriaxone to make sure they remain hemodynamically stable. We really do this workup (CBC, retic, blood culture and ceftriaxone, CXR if any respiratory symptoms) for any sickler patient that comes in regardless of age. What do you do with adults in the ED?