Sickle Cell Crisis – Infections

Information for parents and carers

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Introduction

This leaflet aims to provide you with general information about the signs and symptoms your child may have when they are having a sickle cell crisis. If you are ever worried about your child please contact your Sickle Cell Team or take your child to the Accident and Emergency Department.

What is an infection?

An infection is something that is caused by different types of viruses and bacteria. Infections are one of the commonest triggers for a sickle cell crisis. They can occur in the blood, lungs, spinal fluids, kidneys and bladder.

What are the signs and symptoms of an infection?

• Temperature over 38 °C
• Shaking & shivering. This is known as a rigor.
• Chills
• Cough
• Nausea (feeling sick)
• Rash

What should I do if I think my child has an infection?

If your child has any of the above symptoms you need to take your child to hospital to be reviewed. High temperatures are a medical emergency so if your child has a temperature they must be reviewed straight away. If your child has a temperature give them a dose of Paracetamol (if they haven’t already had some in the last four hours), Paracetamol will help to bring the temperature down. Do not exceed the recommended dosage for your child’s age.

What is the treatment for an infection?

The doctor will check your child to see if they can find the source of the infection. Your child will have a blood test and may have an X-ray or urine test.

Your child will be given antibiotics. If your child is well enough then these antibiotics will be given by mouth and you may be able to take them home. If your child is unwell or has signs of infection they will be admitted to the hospital and given antibiotics through a vein (intravenous). Your child may also be given intravenous (IV) fluids. They will also be given medicine to control their temperature.

What if my child is taking Hydroxycarbamide?

If they have a temperature above 38°C you should ensure they have their full blood count checked

When will my child be able to go home?

If your child has an infection they may have to stay in hospital for a few days. You can take your child home when they haven’t had a temperature over 38°C for 24 hours. Your child may be given antibiotics given by mouth to take home with them. It is important to restart your child’s penicillin when the course of antibiotics has finished.

Will my child get an infection again?

Your child may get an infection again. If you do notice your child experiencing the same symptoms again take them to the hospital for review.

How can I prevent my child getting infections?

Hand Washing

Washing your hands is one of the best ways to help prevent getting an infection. You should wash your hands with soap and clean water.
When to wash your hands:

Before

• Making food
• Eating

After

• Using the bathroom
• Blowing your nose, coughing, or sneezing
• Touching things that can carry germs, such as:
  • Nappies or a child who has used the toilet
  • Food that is not cooked (raw meat, raw eggs, or unwashed vegetables)
  • Animals or animal waste
  • Rubbish

Food Safety

Bacteria, called salmonella, in some foods can be especially harmful to children with sickle cell disease. To stay safe when cooking and eating:

• Wash hands, cutting boards, counters, knives, and other utensils after they touch uncooked foods.
• Wash vegetables and fruit well before eating them.
• Cook meat until it’s well done. The juices should run clear and there should be no pink inside.
• Do not eat raw or undercooked eggs.
• Do not eat raw or unpasteurised milk or other dairy products (cheeses). Make sure these foods have a label that says they are “pasteurised.”

Immunisations

Immunisations are an effective way to prevent many serious infections. Children with sickle cell disease should get all the regular childhood vaccines, plus a few extra.

The extra vaccines are:

• Flu vaccine (influenza vaccine) every year after six months of age. Everyone in the household should also get this immunisation every year.
• Pneumococcal vaccine (called Pneumovax) at two years of age and a booster every five years after that.
• Hepatitis B.
• Meningitis B, Meningitis ACWY

Penicillin

The antibiotic penicillin can help prevent your child getting some forms of infections. Your child should take penicillin (or any other antibiotic prescribed by a doctor) twice a day.

Further information

If you have any questions or want any further information please contact your Sickle Cell Team on 0151 252 5070.

Useful websites

www.sicklecellsociety.co.uk

Alder Hey Children’s NHS Foundation Trust is neither liable for the contents of any external internet site listed, nor does it endorse any commercial product or service mentioned or advised on any of the sites.

This leaflet only gives general information. You must always discuss the individual treatment of your child with the appropriate member of staff. Do not rely on this leaflet alone for information about your child’s treatment.

This information can be made available in other languages and formats if requested.

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