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Peds ID Abx QOTW #18 Answer

a) Reassure the patient he has a virus and recommend supportive care

b) Order a respiratory PCR panel (Biofire)

f) Admit for further work up given Hgb and fevers

• Patients with sickle cell anemia who are febrile are at increased risk of invasive bacterial illness due to their functional asplenia.
• NHLBI guidelines recommend work-up and empiric antibiotic therapy for bacterial disease in patients with fever of 38.5 or higher, even if well-appearing and with viral symptoms
– Although this patient does not meet the fever cut-off, admission for observation and work-up may be indicated depending on other circumstances such as social support, transportation availability for return visits, and prior medical history
• A viral respiratory PCR panel can be useful in pinpointing the cause of the patient’s symptoms, particularly if symptoms are persisting on follow-up visit