Acute chest syndrome, a distinctive manifestation in sickle cell disease – A case study

Abstract

Acute chest syndrome is the most common cause of death and second most common cause for hospitalization of the adult population suffering from sickle cell disease. Therefore, it is important to make the diagnosis and begin treatment quickly and for this clinician must have a high degree of suspicion. Here, we report the case of a 27-year-old male with homozygous sickle cell disease (SS pattern) since childhood who presented with complaints of high-grade fever with chills, dry cough, chest pain, joint pain, and breathlessness? MMRC Grade I. The patient was stable on admission, but he had recurrent fever spikes. Chest X-ray posteroanterior view was suggestive of right lower lobe consolidation. Contrast-enhanced computed tomography of the thorax revealed consolidation in the superior and posterior basal segments of the right lower lobe. He developed sudden onset of breathlessness and severe chest pain and abdominal pain and saturation drop on the 4th day of admission, and he was put on oxygen support. There was a fall in his hemoglobin. After appropriate management with intravenous (IV) antibiotics, IV analgesics, hydroxyurea, IV fluids resuscitation and blood transfusion, the patient was clinically better and was discharged home safely. Significant improvement was noted on subsequent follow-up.