Acute chest syndrome - sickle cell disease

Case contributed by Miriam Leiderer
Diagnosis almost certain


Patient of sub-saharan ethnicity presenting with acute onset chest, back and leg pain and shortness of breath

Patient Data

Age: 13 years
Gender: Male

On admission


Chest x-ray on admission shows slightly increased density in the left lower zone.

Bilateral opacities and left lower lobe atelectasis with silhouetting of the left diaphragm.

Day 3, under therapy


Markedly improved ventilation bilaterally.

Day 10, follow-up


Opacities and left lower lobe atelectasis have resolved completely.

Case Discussion

This case shows acute chest syndrome in a child with sickle cell disease. The patient presented with a pain crisis and increasing respiratory symptoms. On day two, an exchange transfusion was initiated, after which the patient recovered.

Other than blood transfusions, treatment of acute chest syndrome includes broad-spectrum antibiotics, bronchodilators, and supportive care. 

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