Why you should never ignore a fever

It is essential that if you have Sickle Cell or have undergone splenectomy for your Thalassemia, that you have a working thermometer at home and know how to use it. They cost just a few dollars and can be life saving. If you or your child has a fever >38.3°C they must seek urgent medical attention. A fever should never be ignored in patients with Sickle Cell. This is because the spleen, which is the organ that helps to fight certain bacterial infections, becomes non-functioning very early on in life. As a result, patients are unable to fight infections as well as the general population and require prompt administration of antibiotics. The bugs that you are most prone to include those responsible for meningitis, pneumonia and infections of the bones or joints. Infections that can be treated at home with oral antibiotics the next day, often will become overwhelming in patients with Sickle Cell or Thalassemia if antibiotics are not started immediately. You may also not feel that unwell, but it is still important to see a doctor urgently if you have a fever.

 

When you attend the Emergency Department (ED) you must ensure they understand you have Sickle Cell and are predisposed to serious infections, and that you have had a fever. You should be asked to have blood work drawn including blood cultures as well as a chest xray and culture of the sputum and urine. You will be commenced on intravenous antibiotics even before any results are back. If you are taking Hydroxyurea, we advise this is stopped for the duration of a febrile illness, as it can potentially reduce your body’s ability to fight the infection.

 

If you are very unwell with an infection, you may be transferred to an area of the hospital where you can be more closely monitored, such as the ICU (Intensive Care Unit). You may also be advised to have a blood transfusion if you are becoming very sick as a result of an infection.

 

Remember, that patients with Sickle Cell Disease can get malaria and if you plan to travel to a malaria-endemic region, you must take suitable prophylaxis and precautions. If you have recently taken travel abroad, you must inform the medical team of this.

Once you are recovered, it is important that you ensure you are up to date with all your vaccinations to help prevent further infections in the future.

 

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