When someone with sickle cell disease gets a fever, it can be a sign of a serious infection.

Your child stayed in the hospital so healthcare providers could check them often and do tests for different types of infections. Your child was given an antibiotic and fluids through an IV (intravenous line).

Since your child looks well and there are no signs of a serious infection, they can now be cared for at home.

It's extremely important to follow your healthcare provider's instructions, stay in close contact with your hematology care team, and get medical help right away if your child has any new or worsening symptoms.

Follow your healthcare provider's instructions for:

• When your child should follow up
• Giving your child any antibiotics by mouth
• Any special instructions for taking your child's temperature. Usually, this means:
  • Taking your child's temperature when they seem ill, feel warm, have chills, or complain of not feeling well 
  • Using a rectal (in the bottom) thermometer for babies and young children and an oral (in the mouth) thermometer for older kids and teens

General care:

• Be sure that all healthcare providers know the best way to get in touch with you for the next few days. Answer calls and check your messages regularly. Some blood tests that check for bacteria can take several days in the lab. If the blood test shows bacteria, your child needs to go to the ER right away.
• Keep giving your child their usual daily medicines.
• Be sure your child drinks plenty of liquids.
• Let your child rest until they feel well enough to return to normal activities.

Your child:

• Gets a new fever of 100.4°F (38°C) or higher and/or chills after being fever-free for 24 hours
• Develops new symptoms such as cough, chest pain, headache, belly pain or swelling, pale skin, or extreme tiredness

Your child:

• Has a fever that is getting higher
• Seems to be getting sicker
• Isn't drinking at all or has signs of dehydration (not enough water in the body), such as a dry or sticky mouth, sunken eyes, less pee or darker pee than usual, little or no tears when crying, or unusual sleepiness
• Has vision changes, weakness, trouble breathing, a seizure (uncontrolled shaking movements), or is difficult to wake up

If you can't get in touch with your care team, or you are very worried about your child, call 911 or take your child to the ER. If you call 911, tell emergency responders that your child has sickle cell disease.

Why is fever in someone with sickle cell disease serious? Fever in someone with sickle cell disease is an emergency. The spleen helps fight infections, but sickle cell disease can damage the spleen so it stops working well. Without a healthy spleen, the body can't fight off certain bacteria (types of germs that cause infections). This means a mild illness in someone with sickle cell disease can quickly become dangerous. A fever is often the only sign that a serious infection is starting, and it can get worse fast — sometimes within hours. Any fever of 100.4°F (38°C) or higher in a child with sickle cell disease should be checked by a healthcare provider right away.

Can an infection trigger other sickle cell problems? Yes. Illness and fever can sometimes lead to pain episodes, dehydration, acute chest syndrome (a serious lung problem), or worsening anemia (not enough healthy red blood cells). This is one reason healthcare providers take fever very seriously in children and teens with sickle cell disease.

How can I lower my child's chance of getting an infection? It helps to:

• Keep regular appointments with your healthcare providers.
• Have your child and all family members wash hands well and often and get all recommended immunizations (vaccines).
• Keep your child away from people who are sick.
• Seek medical care right away if your child has a fever of 100.4°F (38°C) or higher.