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Case of the Week 296 
What's the most likely diagnosis?
- 27 year-old male with sickle cell disease, cough and fever
- Pneumothorax
- Pericardial effusion
- Acute Chest Syndrome
- Dislocated shoulder
- Congestive heart failure
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Answer:
3. Acute Chest Syndrome
More (Click Discussion Tab)
Acute Chest Syndrome
General Considerations
- Leading cause of death amongst patients with sickle cell disease
- Syndrome is characterized by
- New airspace disease on chest x-ray, and one or more of the following:
- Fever (variable)
- Cough
- Sputum production
- Shortness of breath
- Hypoxia
- Exact cause is unknown
- Most often affects those with homozygous sickle cell and sickle cell-beta thalassemia genotypes
- More common in the winter, in younger individuals, and after surgery
- More severe in adolescents and adults (>20) than in children
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