A fever can be a sign of a serious infection in kids with sickle cell disease. The ER care team didn't find a serious infection, so your child can now go home. Follow these instructions to care for your child.

• Keep giving your child the usual daily medicines unless the ER health care team told you to stop them.
• Give any new medicines prescribed by the ER health care provider.
• Be sure your child drinks plenty of liquids.
• Let your child rest until they feel well enough to do normal activities.
• Make a follow-up appointment with your child's specialist (hematology doctor) to review how your child is doing.

Your child:

• has another fever of 101°F (38.3°C) or higher and/or chills after being fever-free for 24 hours
• is coughing a lot
• has chest pain or any trouble breathing
• has pain that is not helped by medicines at home
• is extremely tired
• has pale skin
• gets a severe headache
• has severe abdominal pain or swelling

The specialist knows your child's health better than any other doctor. So it's always best to call your hematology doctor when there's a problem.

Your child:

• has trouble seeing
• has weakness in part of the body
• has a seizure
• is hard to wake up
• struggles to breathe

When you call 911, tell emergency responders that your child has sickle cell disease.

Why is fever a problem for kids with sickle cell disease? A fever can be an early warning sign of an infection or other problem like acute chest syndrome.

Kids with sickle cell disease are more likely to get infections in their blood and other places, mostly because the sickle cells damage the spleen over time. The spleen's job is to filter out germs from the blood that cause infection. When it's damaged, it can't do that properly.

What will health care providers in the ER do? When kids with sickle cell disease and a fever come to the ER, the health care team will ask questions and do a careful exam and some blood tests. They'll give the child antibiotics before the test results come back, in case there's an infection with bacteria (a type of germ). Unless they think there's a serious medical problem, the team will send the child home from the ER.

Some blood tests take several days in the lab. There's a small chance that a blood test will later show bacteria after a child has gone home from the ER. If this happens, the health care team will contact the family to ask them to bring the child back to the ER to be checked again. So after an ER visit, make sure to answer calls or return messages from the ER. It could be about lab updates that are important to take care of right away.