Description

Rincon-Lopez et al reported a score for evaluating a child with sickle cell disease and fever. This can help to decide which patients need antibiotics and which do not. The authors are from multiple institutions in Madrid, Spain.


Patient selection: age <= 18 years, sickle cell disease, fever

 

Exclusions: hematopoietic stem cell transplant, incomplete testing, lack of parenteral consent

 

Parameters:

(1) serum C-reactive protein (CRP) in mg/dL

(2) serum IL=6 in pg/mL

(3) oxygen saturation in percent

 

Parameter

Finding

Points

serum CRP

<= 3 mg/dL

0

 

> 3 mg/dL

2

serum IL-6

<= 125 pg/mL

0

 

> 125 pg/mL

1

oxygen saturation

>= 92%

0

 

< 92%

1

 

total score =

= SUM(points for all of the parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 4

 

Score

Percent Severe Bacterial Infection (Confirmed or Suspected)

Management

0

2.6%

no empirical antibiotics

1 or 2

22%

at least 1 dose ceftriaxone

3 or 4

100%

empirical broad-spectrum antibiotics and hospital admission

 

Performance:

• The area under the ROC curve was 0.91 for confirmed and 0.86 for possible severe bacterial infection.


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