Acute chest syndrome - sickle cell disease
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Patient of sub-saharan ethnicity presenting with acute onset chest, back and leg pain and shortness of breath
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.
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.