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Master Thesis

Risque bactériémique et prise en charge des drépanocytaires fébriles de moins de trois ans

Abstract : Background : Children under 3 years old with sickle cell disease (SCD) have a high propensity to bacteremia because of compromised immune function. Fever is a symptom of bacteremia. The “Haute Autorité de Santé” (high authority of health) (HAS) has published guidelines for the management of fever in SCD children under 3 years old. Objectives : We aimed to evaluate the bacteremia risk in children under 3 years old referred to Pediatric Emergency Departments (PED) for fever. The second objective was to evaluate adherence to HAS guidelines. Methods : A retrospective review of health records of children with SCD who went at PED for fever between 1st January 2009 and 31th December 2012 in 7 reference centers of SCD in Ile-de-France (Paris region). Results : . A total of 507 consultations on 179 patients were analyzed. 3 patients (0,6%) presented bacteremia. The three pathogenic agents were Salmonella enterica, Escherichia coli and Enterobacter cloacae. No blood culture was positive for Streptococcus pneumoniae. HAS recommendations were followed entirely in 30% of cases only. Blood cultures were performed in 60% of cases. High fever was shown to be the only predictor of bacteremia. Conclusion : A very low rate of bacteremia was found, none implicating Streptococcus pneumoniae. In most cases, HAS guidelines are not followed, that is why they could be discussed
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Master Thesis
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Submitted on : Friday, January 8, 2016 - 12:48:07 PM
Last modification on : Monday, October 19, 2020 - 11:06:24 AM


  • HAL Id : dumas-01252840, version 1


Marie Saunier-Pernaudet. Risque bactériémique et prise en charge des drépanocytaires fébriles de moins de trois ans. Médecine humaine et pathologie. 2015. ⟨dumas-01252840⟩



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