Predicción del riesgo de infección bacteriana grave en niños con enfermedad de células falciformes

Résumé

Children with sickle cell disease (SCD) are at risk of severe bacterial infection (SBI), mainly due to functional asplenia. However, in recent decades, the incidence of these infections has decreased in these patients, especially because of the introduction of preventive measures such as penicillin prophylaxis and vaccination. Despite this fact, due to their potential risk, they usually receive treatment with broad-spectrum antibiotics when they develop fever, with hospital admission in many cases. Some clinical and laboratory parameters have been described as markers of SBI in these patients, with different results. However, none among these parameters has proved to differentiate safely the etiology of fever in these children. Proinflammatory cytokines have been studied in patients with SCD at steady-state and with vaso-occlusive crises, but they have not been studied in cases of infection...