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April 1979

Sickle Cell Disease

Author Affiliations

Division of Pediatric Hematology/Oncology and CommunicableDiseases University of Southern California School of Medicine 1129 N State St Los Angeles, CA 90033

Am J Dis Child. 1979;133(4):448. doi:10.1001/archpedi.1979.02130040102029

Sir.—A recent Journal report by Buchanan and Glader entitled, "Leukocyte Counts in Children With Sickle Cell Disease" (132:396-398, 1978), concluded in part that "an absolute band count greater than 1,000/μL suggests bacterial infection in children with sickle cell anemia." They found such a level in 14 of 16 episodes of bacterial infection but in only three of 35 episodes of vaso-occlusive crisis.

In an attempt to evaluate this finding, we reviewed our experience with 15 episodes of septicemia and ten of meningitis that have been reported in part in a previous communication.1 Cases were selected on the basis of age (younger than 18 years) and a positive bacterial culture of blood or CSF. In addition, we reviewed the records of 30 children hospitalized for painful crisis in whom infection was not considered a contributing factor. The first leukocyte and differential cell count obtained within 24 hours of the

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