Early splenomegaly in homozygous sickle-cell disease: An indicator of susceptibility to infection.

135 children with homozygous sickle-cell (SS) disease diagnosed at birth have been followed for 1--5 years. Severe bacterial infections were confined to those in whom the spleen was first palpable at or before 1 year of age and were commonest in those in whom the spleen was first palpable at or before age 6 months. Regular follow-up of children with SS disease diagnosed at birth will identify children particularly at risk of severe infections.