Prolonged Fever in a 3-Year-Old With Sickle Cell Disease.

Pediatricians face a diagnostic dilemma when young patients with sickle cell disease (SCD) have prolonged fevers. SCD is a potential immunocompromised state because of functional asplenia. Most children with hemoglobin variant SS (Hb SS) have decreased or absent splenic function by the age of 2 years. These patients are at substantial risk of life-threatening infections, especially with encapsulated organisms and serious complications such as vaso-occlusive crisis and acute chest syndrome. We present a 3-year-old male, diagnosed with SCD with symptoms of fever, rash, and enlarged spleen and liver. Despite a 6-day course of intravenous (IV) antibiotics, his fevers persisted, and the inflammatory markers remained elevated. This clinical presentation prompted further investigations into a potential systemic etiology. [ABSTRACT FROM AUTHOR]