Practice Variations in Care of Children with Sickle Cell Disease and Fever

National evidence-based guidelines recommend that children with sickle cell disease and fever undergo a complete blood count, reticulocyte count, and blood culture followed by administration of broad-spectrum parenteral antibiotics. Admission is recommended for patients with any of the following: ill appearance, temperature >40°C, white blood cell count >30 x 10⁹/L or <5 x 10⁹/L, platelet count <100 x 10⁹/L, or hemoglobin <5 g/dL. These investigators retrospectively evaluated pediatric emergency department (ED) practice patterns in the evaluation and management of children aged 3 months to 18 years with sickle cell disease and fever >38.5°C.

During a 1-year period, 4853 patients with sickle cell disease presented with fever to one of 36 U.S.…