Background Pediatric Q fever endocarditis (PQFE) is a rare but serious infection caused by Coxiella burnetii. Diagnosis is often challenging due to nonspecific symptoms and the difficulty in culturing the bacteria. Objectives To describe epidemiological, clinical, and outcome data of PQFE in the Gulf Cooperation Countries (GCC). Methods It is a retrospective, descriptive study; data from patients admitted to a tertiary hospital in Saudi Arabia over the past 5 years were analyzed, supplemented by a review of all published PQFE cases in the GCC. Results Eighteen cases of chronic Q fever endocarditis in the GCC were identified. Three of these cases, comprising our series, occurred within the last 5 years, while the remaining fifteen were previously reported. The majority of cases originated in Saudi Arabia and were associated with a history of cardiac surgery for congenital heart malformations. Clinical presentation was typically atypical, characterized by fever, anemia, and hepatosplenomegaly. Diagnosis in all cases relied on serology, with a mean diagnostic delay of 8.3 months. Despite most patients receiving appropriate treatment with doxycycline and hydroxychloroquine, five required cardiac surgery, two experienced relapses, and one patient died. Conclusion PQFE is a rare disease with a significant diagnostic delay. Increased awareness among physicians, particularly pediatricians and cardiologists, is crucial for timely diagnosis and improved patient outcomes.
Background Antimicrobial medication errors (AMEs) pose critical threats to patient safety and fuel the global rise of antimicrobial resistance. This study retrospectively examines AMEs between 2022 and 2024 at a tertiary care hospital in Riyadh, Saudi Arabia, along with its affiliated community health centers. Objectives The study aimed to identify prescribing vulnerabilities, assess severity outcomes, and propose targeted interventions to enhance safety and stewardship practices. Methods This retrospective cohort study was employed to analyze AME, utilizing electronic health records, pharmacy databases, and institutional incident reporting systems reviewed by the Medication Safety Committee across the prescribing, transcribing, dispensing, and administration phases. Data were stratified by type, severity category, drug class, duration, location, and staff role with cross-validation through pharmacy audits. Results Prescribing errors consistently dominated across all 3 years, 71.4% (2022), 66.7% (2023), and 68.0% (2024), indicating entrenched clinical vulnerabilities. Dispensing errors steadily decreased over the study period, while supply and logistic errors spiked to 6.3% in 2023 before declining in 2024. Augmentin, cefazolin, azithromycin, amoxicillin, meropenem, and vancomycin were the most error-prone agents. Near-miss incidents (Category B) comprised the majority of reports, and hazardous conditions (Category A) rose notably in 2024. Multidisciplinary error reporting showed pharmacists and physicians as primary identifiers. The heatmap highlights declining errors in inpatient units, rising risks in community centers. Conclusion The analysis highlights persistent prescribing risks and emerging operational challenges in a tertiary care hospital’s antimicrobial management. Targeted education, enhanced digital systems, and site-specific interventions are essential for mitigating errors and aligning with global stewardship frameworks.
Background Deliberate self-harm (DSH) involves non-suicidal acts of intentional self-injury used to cope with emotional distress. It is a pathological behavior, recognized as a strong predictor of suicide. Adolescents, undergoing intense developmental changes, are particularly susceptible. The COVID-19 pandemic worsened mental health issues, potentially increasing DSH rates in adolescents. Objectives This study investigates DSH prevalence before and after the pandemic, its risk factors, and implications for public health. Methods A cross-sectional study was conducted using the Lifestyle-Coping-Questionnaire administered in a Level II hospital’s Pediatrics outpatient clinic. The sample included 319 adolescents (12–18 years, M = 14.85) from 2019 (n = 159) to 2023 (n = 160). Statistical analysis involved logistic regression for univariable and adjusted multivariable analyses. Results DSH prevalence was 29.8% (n=95), with an 8.0% post-pandemic increase (P = 0.121). The most frequently used method was cuts (72.6%), predominantly on the upper limbs (84.1%). Among adolescents with DSH, 34.7% sought help, mainly from siblings/friends (72.7%). Additionally, 42.1% expressed a desire to die, and 15.8% mentioned seeking attention. In multivariable logistic regression, significant risk factors included health problems, lack of physical exercise, former smoking, conflicts with a partner, history of attempted suicide/DSH in family/friends, and online search for self-harm methods. Exposure to negative life events correlated significantly with DSH, including difficulty making friends, bullying, parental conflicts, violence, concerns about sexual orientation, and non-consensual sexual relationships. Drug consumption, alcohol intake ≥2 times/month, and a low World Health Organization’s well-being index were also significant for DSH. Conclusion DSH is a significant public health concern that is highly prevalent, causes substantial impairment, and is not readily apparent in most cases. This study highlights key risk factors for the early detection and prevention of DSH.
Background Antimicrobial stewardship plays a crucial role in optimizing antibiotic use to improve patient outcomes and combat resistance. One key strategy is narrowing the spectrum of empirical antibiotics once culture and sensitivity results are available. This targeted approach reduces unnecessary exposure to broad-spectrum agents, preserving their effectiveness. Timely de-escalation also minimizes adverse effects and helps maintain a balanced microbiome. This research study intends to understand antimicrobial susceptibility patterns in the Maternity and Children Hospital. It is of more than 6-year retrospective study (2018–2038), then the last 6 months of 2024 (as the 2024 first 6 months) data is not available. Objectives The aim of the study is to analyze trends in the common organism’s frequency and in antimicrobial susceptibility patterns within the Maternity and Children Hospital in Dammam, Saudi Arabia. Methods The study will use a nonprobability sampling method and will focus on clinically available isolates employing antibiograms and confirmatory tests through the American Proficiency Institute and Phoenix100 automated system. The studies’ anticipated outcomes include insights into current susceptibility patterns, trends over the study period, and an assessment of implications for empirical antibiotic choices. Ethical considerations prioritized: data anonymity, nonmaleficence, and research integrity. This research will provide valuable contributions to addressing the common antimicrobial resistance challenges in maternal and pediatric healthcare, offering a foundation for evidence-based clinical decisions and global efforts against common antimicrobial resistance. Results This multiyear study provides a comprehensive overview of antimicrobial susceptibility patterns across key pathogens. ESBL-producing Escherichia coli and Klebsiella remained under 30%, supporting the use of third-generation cephalosporins in stable, localized infections, while carbapenems are preferred for serious or ESBL-related cases. AmpC producers like Citrobacter and Enterobacter require avoiding cephalosporins and piperacillin-tazobactam, favoring carbapenems and aminoglycosides. Acinetobacter showed unexpectedly high susceptibility, while Stenotrophomonas demonstrated resistance to ceftazidime, limiting its empirical use. Gram-positive organisms, including declining MRSA and stable MSSA, support tailored therapy, with vancomycin and linezolid reserved for invasive infections. Fungal pathogens retained broad antifungal susceptibility, affirming current therapeutic strategies. Conclusion This multiyear study emphasizes the importance of local antimicrobial susceptibility data in guiding empirical treatment and stewardship. Integrating stewardship principles and global guidelines helps optimize antibiotic use, reduce resistance, and prevent complications like C. difficile infection.
Antimicrobial resistance (AMR) remains a pressing global health threat, and in Saudi Arabia, national surveillance trends continue to demonstrate rising resistance among key pathogens. In response, a national evidence-based guideline for hospital-based antimicrobial stewardship programs (ASPs) was developed to guide the implementation of systematic interventions that promote optimal antimicrobial use. The Saudi Pediatric Infectious Diseases Society, in partnership with national and academic partners, led the adaptation of the 2018 Infectious Diseases Society of America/ Society for Healthcare Epidemiology of America ASP clinical practice guideline (CPG) using the king saud university (KSU)-Modified-ADAPTE methodology. Twenty-seven clinical questions were prioritized to formulate 31 recommendations categorized across six sections: antibiotic utilization, optimization strategies, microbiology and laboratory diagnostics, special populations, outcome measures, and organizational support. It included CPG implementation tools (i.e., proposed ASP committee structure, key performance indicators, audit templates, integration guidance aligned with Saudi Ministry of Health and Public Health Authority frameworks, patient health educational material, and patient experience stories). This CPG was registered in the PREPARE registry and reported using the RIGHT-Ad@pt reporting checklist for adapted CPGs. It represents a milestone in Saudi Arabia’s coordinated AMR containment strategy, providing a standardized and scalable model for ASP deployment across hospital settings.
Background Pertussis, or whooping cough, is a highly contagious respiratory infection produced by Bordetella pertussis. Pertussis in infants may produce serious sequelae, such as hyperleukocytosis, an extreme elevation in white blood cell number, for which elevated morbidity and mortality are reported. Pertussis toxin is thought to be primarily responsible for the pathophysiology of pertussis-related leukocytosis, but it is not well understood. Objective The aim of this study is to define the clinical presentation, laboratory findings, therapeutic options, and course of six children with confirmed or suspected pertussis, with a focus on correlation with leukemoid reactions and the investigation of exchange transfusion treatment. Methods We retrospectively reviewed six cases of infant pertussis infection confirmed by PCR with leukocytosis necessitating admission to the Pediatric Intensive Care Unit between June 2024 and February 2025. Treatment included supportive therapy, hyperhydration, simple blood transfusion, and/or exchange transfusion. Results All six patients presented with varying levels of leukocytosis consistent with leukemoid reaction, with WBC counts ranging from 33.9 to 127 × 109/L. Progressive normalization of the WBC counts was seen with interventions such as blood transfusion, hyperhydration, and exchange transfusion. Five patients were discharged in a stable state without major complications, and despite intensive management, one preterm infant died. Conclusion Pertussis in early infancy, especially in preterm or poorly vaccinated neonates, can progress rapidly, frequently leading to severe leukocytosis and cardiopulmonary compromise. Leukemoid reaction can be a marker of disease severity and poor outcome. Prompt recognition of the disease, immediate respiratory support, and proper consideration for exchange transfusion are key to improving survival. The series highlights the urgent need for prevention of pertussis through maternal vaccination and vaccination of infants early in life.
Background Sepsis is a life-threatening condition characterized by organ failure resulting from an abnormal immune response to an infection. Diagnostic biomarkers are crucial tools for determining the presence or absence of disease and for monitoring clinical conditions. C-reactive protein (CRP) and procalcitonin are two key biomarkers frequently utilized in clinical practice. Objectives This study aimed to evaluate the diagnostic accuracy and clinical utility of inflammatory markers, specifically Spell out and CRP, in detecting sepsis among neonates and infants under 3 months of age. Methods A 5-year retrospective cohort study was conducted at King Abdullah Specialized Children’s Hospital, Riyadh, Saudi Arabia. All patients under the age of 3 months who were diagnosed with sepsis. Statistical analysis used is the Statistical Package for the Social Sciences. Results A total of 264 patients were reviewed in this study. Among these, 115 patients were classified as septic based on abnormal results in urine culture, blood culture, or cerebrospinal fluid. Lethargy was observed in 31 (60.8%), poor feeding was noted in 43 (41.7%), and Irritability was reported in 16 (15.7%) of septic cases. PCT was abnormal in 59 (57.3%) septic patients, while CRP was abnormal in 25 (24.3%) septic patients. Regression analysis of the association between inflammatory markers and sepsis showed no statistically significant association between PCT and CRP with sepsis. Conclusion Despite the high prevalence of abnormal PCT levels among our pediatric patients, our analysis revealed no statistically significant association between PCT and CRP biomarkers and the development of sepsis. Further investigations are warranted to identify the most effective inflammatory marker for detecting neonatal sepsis both in our region and globally.
Background Pediatric urinary tract infections (UTIs) are a global public health concern, exacerbated by rising antibiotic resistance rates, including extended-spectrum beta-lactamase (ESBL) producers. In Saudi Arabia, the epidemiology of pediatric UTIs varies regionally, necessitating localized studies to guide effective management strategies. Objectives This study aims to analyze the epidemiology and antibiotic resistance profiles of pediatric community-acquired UTIs in a tertiary care setting at King Saud Medical City (KSMC), Riyadh, to inform localized management strategies. Methods A retrospective study was conducted analyzing data from 803 pediatric patients (aged 1 month to 14 years) with initial UTIs at King Saud Medical City, Riyadh, between 2016 and 2018. Demographic data, urine culture results, and antibiotic resistance profiles were extracted from electronic medical records. Statistical analyses, including chi-square tests and logistic regression, were used to assess associations and predictors of antibiotic resistance. Results Escherichia coli was identified as the most common uropathogen (40.5%), followed by Klebsiella pneumoniae (21.5%) and Enterococcus species (12.7%). ESBL producers accounted for 24.61% of the isolates, significantly influencing the choice of empirical therapy. High antibiotic resistance rates were observed, particularly for ampicillin (43%), cotrimoxazole (26.8%), and cefazolin (CFZ; 50%). Notably, the prevalence of ESBL-producing uropathogens varied significantly by gender and pathogen type. Conclusion This study provides important insights into the epidemiology of pediatric community-acquired UTIs and antibiotic susceptibility in Saudi Arabia. Due to the high prevalence of ESBL-producing uropathogens, individualized management strategies for antibiotic use are essential. Local studies are crucial for informing empirical treatment and improving clinical outcomes in managing pediatric UTIs.
Background Syncope is a common symptom in pediatric clinics, with neurocardiogenic syncope being the most frequent etiology. The evaluation approach varies, as does the diagnostic yield. Objectives This study aims to evaluate the demographic and clinical characteristics of pediatric patients who present to specialty clinics with syncope. Methods This retrospective study analyzed the records of pediatric patients seen for syncope in the neurology and/or cardiology specialty clinics at Jordan University Hospital between 2021 and 2024. We examined demographic characteristics, presenting symptoms, investigations, and differential diagnoses. Descriptive statistical analysis was performed using SPSS. Results A total of 147 patients were included, comprising 64 (44%) males. Age ranged from 4 to 18 years, with 92 (63%) patients aged 10–15 years. Neurocardiogenic syncope was the most common diagnosis (108 [73%] patients). Epilepsy was diagnosed in eight patients, and one patient had a cardiac etiology. Among those tested, iron deficiency anemia was identified in 18 (12%) patients, and 31 (21%) patients had vitamin D deficiency. Brain imaging and echocardiography had low diagnostic yield. Conclusion Our findings suggest a predominance of neurocardiogenic syncope, though some patients were diagnosed with serious conditions such as epilepsy and restrictive cardiomyopathy. This study underscores the need to streamline diagnostic protocols to minimize unnecessary tests while ensuring serious etiologies are not overlooked.
Background We evaluated the impact of the Transition Assessment Post Transfer (TAPT) program, a pediatric critical care outreach team (PCCOT) follow-up initiative, on morbidity and mortality outcomes for children who received a pediatric intensive care unit (PICU) consult in the emergency department (ED) and were transferred to an inpatient ward. Objectives The primary objective of this research was to evaluate the impact of the TAPT program on PICU admission rates. Secondary objectives included a description of patient characteristics, PICU length of stay, days on invasive and non-invasive ventilation, and mortality. Methods A retrospective analysis compared pre-TAPT (2014–2017) and post-TAPT (2017–2020) periods. Patients included were those requiring PICU admission within 24 hours of hospital admission from the ED. A subgroup analysis examined patients with a prior PICU consult in the ED. The intervention involved routine PCCOT follow-up for children after PICU consultation or PCCOT activation in the ED, introduced in July 2017. Results An interrupted time-series analysis of 3 years before and after TAPT implementation included 316 children (35% female; mean age 4.8 years) requiring unplanned PICU admission within 24 hours, with 22 (7.0%) having a prior PICU consult in the ED. There were no significant differences in early unplanned PICU transfers, morbidity indicators, or mortality. Conclusions There were no significant differences in PICU transfer rates between the pre- and post-TAPT periods. Further research is needed to improve risk identification for early deterioration and assess the broader impact of TAPT.
Background: Drug dosage errors are mistakes that occur during the prescribing, dispensing, or administering of medications, leading to patients receiving incorrect dosages. Objectives: The aim of the study was to apply health beliefs model (HBM)-based intervention in improving nurses’ beliefs toward drug dosage errors. Methods: A randomized controlled trial was conducted in pediatric wards of hospitals in Mosul from October 5, 2024, to May 1, 2025. The study involved 60 nurses, equally divided between the experimental and control groups. The HBM-based intervention focused on perceived susceptibility and severity, perceived benefits, perceived barriers, and cues to action related to medication dosage errors. The inquiry utilized the Social Science Statistical Package (SPSS) version 26 to analyze the data. The statistical methodologies employed for data analysis and outcome evaluation encompass. Results: The study results showed no significant differences in demographic variables, indicating a homogeneous sample. The training led to an increase in knowledge among nurses, with their mean score rising from 6.866 pre-study to 17.466 in post1 and 16.866 in post2, indicating an improvement from fair to good knowledge. Nurses’ beliefs also showed positive changes in almost all components of the HBM, except for perceived barriers. Conclusion: The study concluded that the HBM-based intervention was effective in enhancing nurses’ beliefs regarding medication dosage errors. The intervention significantly improved their understanding of perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy in relation to the medication safety.
Background Respiratory syncytial virus (RSV) causes lower respiratory tract infections, particularly in children under 24 months of age. This multicenter study explored the demographics, seasonality, clinical features, and outcomes of children with RSV. Objectives To describe the epidemiology, seasonality, clinical characteristics, and outcomes of infants and children admitted with Respiratory Syncytial Virus bronchiolitis Methods An eight-center retrospective cohort study included children less than 24 months old who were admitted with RSV bronchiolitis between January 2018 and December 2021. Patients’ clinical features, respiratory support, management, and outcomes were collected. Results Of the 1585 children included, 1143 (72%) were less than 6-month-old. RSV peaked during the winter months of September to December in 2018 to 2019, but occurred earlier in 2021, with the easing of post-COVID-19 restrictions. The most common clinical features were cough (97.72%), tachypnea (76.15%), and fever (75.9%). Different types of respiratory support were needed, including high-flow nasal cannula (HFNC) in 141 (8.9%) children, Non-invasive ventilation in 341 (21.5%), and intubation in 144 (9.1%). A total of 844 (53.2%) children required admission to a pediatric intensive care unit (PICU) or pediatric high-dependency unit (PHDU). The majority of children recovered uneventfully, while 19 patients died, resulting in a mortality rate of 1.2%. Conclusion To our knowledge, this is the largest cohort study focused specifically on RSV bronchiolitis in infants within the Middle East. The majority were younger than 6 months of age, and coughing, tachypnea, and fever were the most common symptoms. Seasonality differed between the pre- and post-COVID-19 pandemic periods. More than half of the cohort required admission to a PICU or PHDU. All patients who died had either prematurity or chronic comorbidities. Further studies are required to predict the risk factors for critical cases.
Background Chondroblastoma is an uncommon benign cartilaginous tumor of young adults and adolescents, accounting for 1% of all bone tumors. We aim to analyze the imaging characteristics of pathologically proven chondroblastoma, measure the incidence rate of local recurrence of this tumor, and identify factors that may influence its local recurrence. Materials and methods The details of a total of 44 patients with pathologically proven chondroblastoma who underwent surgery and followed up by cross-sectional imaging between January 2006 and March 2021 at the KFSHRC in Riyadh were retrieved from our archive. All available modalities, including plain radiography, CT, and magnetic resonance imaging (MRI), performed at baseline and on follow-up were reviewed and correlated with the histopathological diagnosis. Recurrence was calculated from the date of surgery to the date of recurrence or the date of being lost to follow-up depending on the date of recurrence. The statistical software STATA was used to analyze the data. Results The tumor recurrence rate was 4.55% ( n = 2). Similarly, the residual tumor rate was 4.55% ( n = 2). No metastases were documented. The recurrence-free survival was 93.8% at the 722-day follow-up. More than 95% of lesions demonstrated typical imaging features including: a well-defined lobulated margin, intermediate-to-low signal on T2-weighted images, and perilesional edema. Conclusions This study emphasizes the imaging findings of chondroblastoma, which classically affects skeletally immature patients. Although imaging findings cannot be used to predict recurrence or survival, we obtained excellent prognosis following surgical treatment at our institution.
Paediatric abdominal pain continues to pose a diagnostic challenge in the acute hospital care setting. We describe an eleven-year-old boy who presented to the emergency department with acute-onset, sharp abdominal pain localised to right lower quadrant. Abdominal imaging was diagnostic for epiploic appendagitis (EA), with pathognomonic 'ring sign' and 'central dot' visualised on the axial computed tomography images. He responded well to conservative treatment, including a short course of non-steroidal anti-inflammatory drugs. EA is a lesser-known paediatric entity mimicking surgical conditions. However, steady but sharp and non-migratory characteristic of the pain in either of the lower abdominal quadrants should raise suspicion for EA. Early accurate diagnosis can prevent unnecessary surgical exploration in these patients.
Background:Early identification of childhood malnutrition is imperative to improve overall health outcomes, and more importantly, to start early intervention to decrease the risk of future complications. This study aimed to evaluate new malnutrition Z-score growth indicators for detecting pediatric malnutrition and degrees of severity and compare their accuracy with that of growth chart centiles. Patients and Methods:This retrospective study included 475 pediatric patients from several pediatric nutrition clinics for six months. The participant's weight, height, age, and growth parameters were recorded using both traditional growth charts (centiles) and updated malnutrition indicators (z-scores). The percentage and degree of malnutrition using centiles and Z-scores were compared. Results:In children aged <2 years, the percentage of malnutrition was 4.7% higher when measured using new malnutrition indicators (weight-for-length Z-score) compared with (weight-for-length centiles). Our results also showed 9.6% higher number of malnourished children >2 years of age when BMI-for-age Z-score was used compared to weight-for-height centiles while there were 15.8% higher malnourished children when BMI-for-age Z-score was compared to BMI-for-age centiles for the same group. We found a significant difference (X2 = 202.548, P=<.0001) between the degree of malnutrition in children aged >2 years using BMI-for-age Z-score (normal vs. malnourished) and the degree of malnutrition using BMI centiles (normal vs. malnourished). Approximately 34% of the children classified as normal using centiles were classified as malnourished using Z-scores. Comparing the degrees of Malnutrition, approximately 23% (45 of 196) of children classified as normal based on centiles were classified as having mild malnutrition when Z-scores were used, and 42% (80 of 192) of children who were classified as having mild malnutrition based on centiles were classified as having moderate malnutrition when Z-scores were used. Conclusions:In our study, a higher percentage of children showed malnutrition when assessed using the Z-score (BMI-for-age for children >2 years/weight-for-length for children <2 years of age) than the centiles growth chart.
Objectives:The purpose of this paper is to highlight the impact of a pandemic on the lives of vulnerable members of the community who have experienced or are 'at risk' of experiencing intimate family violence and child abuse in Saudi Arabia. By reviewing the experience in Saudi Arabia in the context of the international literature, the study explores similarities and differences in the impact of the pandemic on family violence. Methods:The study investigated the impact of the COVID-19 pandemic on family violence and child abuse in Saudi Arabia by conducting a comparative analysis of the prevalence of cases, types of abuse, and geographical location of those experiencing violence between the years 2019 and 2020. Data were obtained from the Family Violence Reporting Center 1919 in Saudi Arabia. Results:The study found that the risk of family violence and child abuse increased during the COVID-19 pandemic in Saudi Arabia, similar to findings in other countries. Conversely, there was a decrease in the number of reports due to factors associated with COVID-19. Conclusions:The study highlighted the importance of ensuring that existing policies and services are sufficient to ensure the risks arising from the impact of COVID-19 responses and minimize the negative consequences.
Laryngeal web is a rare congenital or acquired disease that results in airway stenosis. Depending on the severity of atresia, patients with laryngeal web show a wide variety of symptoms ranging from asymptomatic to life-threatening respiratory dysfunction that may require emergency tracheostomy immediately after birth. We report a neonatal case of laryngeal web with 22q11.2 deletion syndrome. Post-delivery, the infant showed dysphonia and had a ventricular septal defect with characteristic craniofacial features. The infant underwent an endoscopic incision of the web and cardiac surgery. Among patients with laryngeal web, 30% have 22q11.2 deletion syndrome. 22q11.2 deletion syndrome is the most common chromosomal microdeletion syndrome and the second most common chromosomal abnormality associated with congenital heart disease. Therefore, if an infant has laryngeal web with comorbidities such as congenital heart disease, 22q11.2 deletion syndrome should be considered in differential diagnosis.
Background: Sickle cell disease (SCD) is a wide prevalence disease worldwide. It has a spectrum of clinical manifestations. However, SCD patients are more susceptible to have a serious bacterial infection (SBI) as compared to other individuals. Objective: The main objective of this study was to investigate the prevalence rate of serious bacterial infection (SBI) in febrile children with sickle cell disease (SCD), whose vaccinations are up to date and are on regular penicillin prophylaxis, presented to the emergency department (ED) to assist in the management approach of such patients. Methods: A retrospective study included febrile SCD children under 12 years of age between 2014 and 2019 at King Saud Medical City (KSMC) in Riyadh, Saudi Arabia. Patients were stratified according to the true culture result of each febrile event. Descriptive statistics were used to report data from the patient's medical records. Results: From 833 febrile events, 40 events were assessed for eligibility with positive culture results. Of these, 10 were excluded due to contamination. The rest, 30 children with confirmed SBI (3.6%, 30/833) (95% CI = 2.4%–5.1%) were recruited. The highest prevalence rate of SBI was for urinary tract infection (UTI) (2.2%, 19/833) (95% CI = 1.4%–3.5%), followed by bacteremia (1.3%, 11/833) (95% CI = 0.7–2.4), osteomyelitis (0.24%, 2/833) (95% CI = 0.03–0.86) and meningitis (0.12%, 1/833) (95% CI = 0.00–0.67). Pneumococcal was the most common isolate among children with bacteremia (46%, 5/11) followed by Salmonella species (36%, 4/11). All the children fully recovered. Conclusion: As the prevalence of SBI, particularly bacteremia, continues to decline with a favorable outcome in our population, ambulatory management practices for well-presented febrile SCD children should be encouraged, for there are no further reasons for admission and the patient can return soon to their hospital if his condition worsens or there is growth in the blood culture. Further effort is needed to determine whether blood culture and empiric antibiotics are necessary for each febrile event in the probable highly active vaccination era.
