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Acute chest syndrome in sickle cell disease — SCE Acute Medicine MCQ

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HardHaematological EmergenciesAcute chest syndrome in sickle cell diseaseSCE Acute Medicine

During a sickle-cell pain crisis, a patient develops fever, hypoxaemia and a new lobar infiltrate with falling haemoglobin. What is the management priority?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Give oxygen, antibiotics, analgesia and assess transfusion

The best answer is “Give oxygen, antibiotics, analgesia and assess transfusion”. This is correct because a new pulmonary infiltrate with respiratory symptoms in sickle-cell disease is acute chest syndrome, which can deteriorate rapidly. Incentive spirometry and careful fluids are added; simple or exchange transfusion depends on severity. Atelectasis, infection and embolism can contribute, so single-cause therapy is inadequate.

Reference: British Society for Haematology acute-chest-syndrome guideline: https://b-s-h.org.uk/guidelines/guidelines/management-of-acute-chest-syndrome-in-sickle-cell-disease