Infections and Sickle Cell Disease

Children and teens with sickle cell disease (SCD) have an increased risk of developing infections. These include:

• Influenza (flu)
  
• Pneumonia
  
• Meningitis
  
• Bone infections
  
• Bloodstream infections
  

If your child has sickle cell disease, infections can be life-threatening. Infection is a leading cause of death in infants and young children with sickle cell disease.

Seek medical care right away if your child has fever or other signs of infection.

Symptoms of infection

Signs and symptoms of infection include: 

• Fever 
  
  • Oral (by mouth) temperature of 101°F (38.3°C) or higher
    
  • Axillary (under the arm) temperature of 100°F (37.8°C) or higher
    
• Chills 
  
• Sweating
  
• Cough
  
• Runny nose
  
• Sore throat
  
• Chest pain 
  
• Shortness of breath, trouble breathing, or fast breathing
  
• Irritability or fussiness
  
• Pale skin color
  
• Throwing up (vomiting) 
  
• Diarrhea
  
• Sleeping more than usual or unable to stay awake
  
• Swelling, tenderness, or redness of the skin or in the area over a bone or joint
  

In some patients, fever may be the only sign of infection.

Causes of infections in sickle cell disease

In most cases, the body can defend itself against harmful germs. But sickle cell disease can weaken your child’s immune system. This is because the spleen does not work properly to filter germs and fight infections. 

The spleen is an organ on the left side of the body under the ribcage. It is about the size of a fist. The spleen works to:

• Fight infection
  
• Make white blood cells
• Create, store, and filter blood 

Sickle cell disease causes red blood cells to become hard, sticky, and shaped like a banana. Sickled red blood cells stick together and clog the blood vessels in the spleen. This leads to damage and keeps the spleen from working properly.

Your child may get infections more easily and infections can be more serious, even life-threatening. 

What to do if your child has fever or signs of infection

A fever is a medical emergency in children with sickle cell disease. Seek medical care right away if you notice fever or other signs of infection in your child.  

Do not give fever reducing medicines such as acetaminophen or ibuprofen for a fever unless instructed by your care team. These medicines can hide infection symptoms. Always check your child’s temperature before giving acetaminophen or ibuprofen.

Take your child to their clinic or local emergency room. Your health care provider will do an exam and order lab tests to find the cause of the infection. They will likely prescribe an antibiotic to treat the infection.

When to call 911

Call 911 or take your child to the nearest emergency room if they: 

• Have a temperature of 101.3°F (38.5°C) or higher
  
• Have trouble breathing
  
• Are unresponsive and cannot talk to you
  
• Cannot wake up from sleeping
  
• Have sudden weakness, loss of feeling, or cannot move a body part

How to prevent infections

You can take steps at home to help your child stay healthy.

Practice proper handwashing

One of the best ways to prevent infection is keeping your hands clean. Wash your hands with soap and water for at least 15–20 seconds or use an alcohol-based hand sanitizer. Be sure your child knows how to wash their hands well. Help young children with handwashing. 

Keep vaccines up to date

Vaccines can prevent many serious infections. Make sure your child gets the vaccines their care team recommends. These vaccines include:

• Flu vaccine every year
• Hepatitis B vaccine
  
• Meningitis vaccine
  
• Pneumococcus (pneumonia) vaccine
  
• Other vaccines as your care team recommends
  

Give medicines as instructed 

All infants and young children with sickle cell disease are prescribed daily penicillin to help prevent infections. Some individuals with sickle cell disease may need to take lifelong penicillin. Be sure your child takes all medicines as instructed. Talk to your health care provider or pharmacist if you have questions.

Treat infections early

It is not always possible to prevent infections. Your child can follow all these guidelines and still get infections. Seek medical care so that infections can be caught early. 

• Watch for signs and symptoms of infection.
  
• Talk to your care team about what to do if your child has a fever or gets sick. 
  
• Know what to do if your child has a fever after hours or on the weekend.
  
• Know when to seek emergency care. 
  
• Let others know about your child’s condition. Have a plan in place for school, travel, and times when other caregivers may be taking care of your child. 
  
• Be sure your child takes all medicines exactly as prescribed.  
  

Talk to your care team if you have questions about infections. Always follow the instructions given by your care team.

Questions to ask your care team  

• What is my child’s risk of infection?
  
• What should I do if my child has a fever?
  
• What is the best way to take my child’s temperature?
  
• How often should I take my child’s temperature?
  
• What are signs that an infection might be getting worse?
  
• When should I call the care team?
  
• What are the best ways to prevent infection?
  

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