Sickle Cell Disease and Fever

Children with sickle cell disease (SCD) are more likely to get infections, especially bacterial infections. The spleen helps to fight infections. In patients with sickle cell disease, the spleen does not work as well. Fever may be the first and only sign of infection.

Infections can cause death in children with SCD, so a fever is a medical emergency.

Signs of Infection

If you are going to give your child Tylenol® or Motrin® for pain or other discomfort, take their temperature first to see if they have a fever. Your child must see a doctor or health care provider RIGHT AWAY if they have a fever.

Some signs of infection are:

  • Fever of 101° Fahrenheit (38.3° Celsius) *
  • Coughing or hard time breathing
  • Breathing very fast
  • Sleeping more than usual
  • Fussy or irritable
  • Pale skin color
  • Throwing up (vomiting) or diarrhea

Daily Penicillin

Daily penicillin prophylaxis helps prevent infections. Penicillin is a medicine that helps kill bacteria. Children with SCD, ages newborn to 5-years-old, should take penicillin 2 times a day. Some children may need to continue taking penicillin after they turn 5.

  • Give your child penicillin every 12 hours. Missing a dose puts them at risk for infections.
  • Liquid penicillin needs to be re-filled every 14 days. If not, it will expire. Refill your child’s prescription before it runs out.
  • Liquid penicillin needs to be kept in the refrigerator.


Vaccines also help to prevent infections. The Prevnar-13 vaccine is recommended for all children, but especially for children with SCD to decrease the risk of severe infection (sepsis). Children with SCD should get recommended vaccines, including the flu shot.

Penicillin and vaccines don’t work 100% of the time. It is still important to take your child to their doctor or health care provider right away with any fevers.


Your child needs to be taken to the nearest emergency department if they have a fever. While there, they will:

  • Have their heart rate, blood pressure, oxygen level, temperature, and respiratory rate measured.
  • Have blood drawn for labs, including blood counts and a blood culture test.
  • Get an intravenous (IV) line in their arm to give antibiotic medicine and fluids.
  • Have chest X-rays or other imaging services done if needed.
  • May be admitted to the hospital depending on their labs and physical exam.

When to Call the Doctor

  • When you are on your way to the emergency department if your child has a fever.
    Our team will tell them you’re on the way.
  • If your child gets sick during the day, call the sickle cell nurses at (614) 722-8914 Monday through Friday, 8 a.m. to 4:30 p.m.
    • If they are not available, please call the Sickle Cell Clinic at (614) 722-3250.
    • On evenings, weekends, and holidays, call (614) 722-2000 and ask for the hematologist on call.

When to Call 911

Call 911 for emergency help if your child:

  • Is breathing slowly or stops breathing.
  • Is unresponsive and cannot talk to you.
  • Cannot wake after a nap.
  • Has sudden weakness, loss of feeling, or cannot move a body part.

Sickle Cell Disease and Fever (PDF), Somali (PDF), Spanish (PDF)

HH-I-221 ©2002, revised 2022, Nationwide Children’s Hospital