No abstract

No abstract

No abstract

In the last 4\m=1/3\years, 12 episodes of Diplococcus pneumoniae bacteremia or meningitis, or both, were observed in ten children with sickle cell anemia. Seven children were under 2 years of age; seven were boys, and three were girls. The infections were frequently fulminant and two patients died in spite of appropriate therapy. Seven patients required packed erythrocyte transfusions. The infections were caused by eight different serotypes of D pneumoniae. Patients with sickle cell anemia accounted for 7.3% of the children admitted with pneumococcal infections. Pneumococcal infections were present in 2.8% of children admitted with sickle cell anemia.

Acute splenic sequestration crises (ASSC) is a potentially life-threatening com plication in young children with sickle cell anemia. The clinical picture includes huge splenomegaly accompanied by signs and symptoms of acute circulatory insufficiency caused by profound anemia. The authors describe 20 such episodes in 14 children aged six to 55 months. Rapid transfusion of packed erythrocytes produced rapid and dramatic improvement. The spleens became nonpalpable in seven to ten days following transfusion. Four children died, four had one or more recurrences, four have splenic involution, and two were splenectomized. The recurrences were within four months of the previous ASSC. "Our current recommendation is to consider splenectomy only after at least two ASSCs."