Bacterial sepsis is more common and potentially life threatening in children with sickle cell disease (SCD). Identification of variables that predict bacteremia may aid clinicians in recognizing patients with SCD at higher risk for sepsis.
To determine whether absolute neutrophil count (ANC) >20×109/L is an independent risk factor for bacteremia in children with SCD and to identify other predictors of bacteremia in this population.
A case-control study was conducted. Subjects were 0 to 18 years of age admitted to a tertiary care pediatric hospital over a 17-year period with SCD and fever at presentation. Cases had bacteremia, whereas controls had negative blood cultures.
Data were analyzed for 40 cases and 120 controls. ANC>20×109/L was significantly more prevalent among cases (odds ratio [OR], 7.0; 95% confidence interval [CI], 2.6-18.9). Cases were more likely to have emesis (OR, 2.9; 95% CI, 1.0-8.4) and a higher proportion of band cells (OR, 1.3; 95% CI, 1.1-1.4) at presentation.
In a febrile child with SCD, an ANC>20×109/L, a higher proportion of band cells, and the presence of vomiting were associated with an increased likelihood of bacteremia.
*Department of Paediatrics, Division of Paediatric Medicine
‡Department of Paediatrics, Division of Hematology/Oncology, The Hospital for Sick Children
†Faculty of Medicine, University of Toronto, Toronto, ON, Canada
The authors declare no conflict of interest.
Reprints: Deena Savlov, MD, FRCPC, Department of Paediatrics, Division of Paediatric Medicine, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada M5G 1X8 (e-mail: firstname.lastname@example.org).
Received June 5, 2013
Accepted October 16, 2013