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. Similarly, septic arthritis must be distinguished from the more common joint effusion associated with acute painful episodes. Blood cultures may be particularly helpful in the setting where infarcted bone is seeded during an episode of bacteremia. Increasing antibiotic resistance among Salmonella isolates is a major problem. Even if in vitro susceptibility tests suggest efficacy for tetracyclines, cephalosporins, and aminoglycosides, these antibiotics often fail.