Pneumococcal Infection and Penicillin

Infection is the major cause of death in children with sickle cell anemia. Infections cause deaths more rapidly and are more difficult to get rid of in patients with sickle cell anemia than individuals without sickle cell anemia.  

An especially serious infection is the pneumococcal bacteria. It causes pneumonia, meningitis (infection of the brain) and septicemia (blood poisoning). This infection is responsible for most deaths in children with sickle cell anemia under three years of age. It is estimated that children with sickle cell anemia are 600 times more likely to get a pneumococcal infection than the general population. Most of the infections occur before three years of age. Thirty-five percent of the children with sickle cell anemia who get a pneumococcal infection die.  


The spleen has two functions to help fight infection. It filters or removes bacteria from the blood stream and makes antibodies that help fight infection outside of the spleen. In a child with sickle cell anemia, the sickled cells block the blood vessels in the spleen so blood can't move through it to be filtered. It also can't make antibodies that fight infection. Bacteria can grow in the blood stream and cause blood poisoning (septicemia).  

Symptoms of Pneumococcal Infection

  • Fever 101F or higher;
  • Crankiness;
  • Unusual sleepiness;
  • Vomiting;
  • Diarrhea;
  • Rapid breathing;
  • Cough;
  • Pale color; and
  • Trouble breathing.

A Fever May Be the Only Symptom at First 

If your child has any of these symptoms, even if over five years of age and/or are on penicillin, the child should be seen by either your private doctor or a doctor in the emergency room as soon as possible. Be sure to share with your doctor that your child has sickle cell anemia. 

Your child will be examined and may have lab work and x-rays to find the cause of the fever. Your child will be given an IV antibiotic and may be sent home on a strong oral antibiotic. Depending on your child's symptoms, they may be admitted to the hospital to be watched closely.

The pneumococcal infection is treatable and complete recovery is possible if the infection is recognized and treated early enough. However, even with treatment, permanent disabilities and death can result.  


Penicillin kills the pneumococcal bacteria before it can cause blood poisoning in a child with sickle cell anemia. It must be taken every 12 hours. If a dose is missed, the body is not protected against the pneumococcal bacteria and blood poisoning can still occur very rapidly. It is important to get your child's penicillin refilled before it runs out.

It is important to remember that your child can still get blood poisoning even though the penicillin is taken regularly. Some bacteria may be resistant to penicillin. If your child develops a fever of 101F or 38.5C or higher, even taking penicillin, they should see a doctor immediately. Other antibiotics can be used to fight the bacteria resistant to penicillin.