Vaso-occlusive Phenomena
Stroke
Ischemic
Hemorrhagic
Acute Chest Syndrome
Diagnostic Criteria
New pulmonary density on chest imaging involving at least one complete lung segment and ≥1 of the following:
Temperature ≥38.5°C
>3 percent decrease in SpO2 (oxygen saturation) from a documented steady-state value on room air
Tachypnea (per age-adjusted normal)
Intercostal retractions, nasal flaring, or use of accessory muscles of respiration
Chest pain
Cough
Wheezing
Rales
Symptoms
Fever
Cough
Chest pain
Shortness of breath
Hemoptysis
Triggers
Infection
Vaso-occlusive Crisis
Pulmonary Embolism
Asthma
Pulmonary Edema
Atelectasis
Opioid induced hypoventilation
Treatment
Antibiotics
Maintaining oxygenation >95%
fluid hydration
pain control
inhaled incentive spirometry
Acute Pain Crisis
Affected Systems
Pulmonary: CP, SOB
CNS: HA
Musculoskeletal: Tender + warm joints, bone pains
GI: Abdominal pain
Other findings: Fever, Leukocytosis
Consider other differentials:
CP/SOB: ACS, ARDS, cor pulmonale, high output heart failure, pneumonia, pulmonary embolism
headache: Stroke, memingitis, CV thrombosis, ocular pathologies
Arthralgias: septic arthritis, acute trauma, avascular necrosis
Abdominal Pains: Splenic sequestration, acute intrahepatic sequela, mesenteric vascular occlusions, renal infarcts.
Sequelae of hemoglobinopathies:
Priapism
Sickle Cell Nephropathy
UTI/Pyelonephritis
Renal meduallary carcinomas
Splenic Sequestration
RUQ/Abdominal pain
Symptomatic cholelithiasis
cholecystitis
acute sickle hepatic crisis
acute intrahepatic cholestasis
Acute hepatic Sequestration
Microbiology reminders to watch out for in asplenic sickle cell patients
Streptococcus Pneumoniae
Haemophilus Infleunza
Non-typhoidal salmonella species
mycoplasma
C. Pneumoniae
Yersinia enterocolitica
Amanda Baroutjian, MD