Pneumococcal septicemia in children with sickle cell anemia. Changing trend of survival

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Abstract
Streptococcus pneumoniae infection has been the predominant cause of death among children with sickle cell anemia (SS). A change was observed in the pattern of progression of septicemia to meningitis and death in nonimmunized SS children who were not receiving prophylactic penicillin despite a persistently high incidence of pneumococcal disease. Of 233 SS children aged < 6 yr observed for 781 person-yr, the overall incidence rate of pneumococcal septicemia was 5.9 episodes/100 person-yr. Prior to July 1972, of 23 children who had pneumococcal septicemia, 8 (35%) died and meningitis developed in 15 (65%). Since July 1972, 11 children have had penumococcal septicemia, but no children died and meningitis developed in only 2 (18%). This decrease in major morbidity is attributed to the establishment of a clinical program that provides close medical supervision of the SS child with fever and the rapid institution of parenteral antibiotic therapy.