Bacterial meningitis should be treated for 10 days or at least 7 days after cerebrospinal fluid sterilization has occurred. On the other hand, if blood, urine, and throat cultures are negative after 3 days and the patient is well, antibiotic therapy can be discontinued and the diagnosis presumed to be a viral illness. If fever persists and cultures are negative, the patient should be reevaluated. Infections in Older Children and Adults Because pneumococcal infections become less frequent after the first decade of life and infections due to other pathogens found in the general population become more common, a systematic bacteriologic evaluation should be used before administering antibiotics. A persistent fever higher than 101 oF should not be assumed to be due to vaso- occlusive crisis.
Infections tend to occur in already damaged areas such as lungs, kidneys, and bones.
Urinary Tract Infections Pyelonephritis in patients with SS disease is difficult to treat, recurs regularly, and is often associated with septicemia. This is particularly serious during pregnancy. Urine cultures are essential before therapy and should be repeated 1 to 2 weeks after cessation of therapy. Treatment consists of antibiotics and hydration. Urologic evaluation and chronic suppressive antibiotic therapy may be appropriate for patients with repetitive infection.