Case 4: Persistent Lung Lesion in a 6-year old Boy with Sickle Cell Disease

Ahmar U. Zaidi; Meret Henry; Michael U. Callaghan

doi:10.1542/pir.2017-0084

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Ahmar U. Zaidi, MD*
Meret Henry, MD, MS*
Michael U. Callaghan, MD*

^*Department of Hematology/Oncology, Children’s Hospital of Michigan, Detroit, MI

AUTHOR DISCLOSURE
Drs Zaidi and Henry have disclosed no financial relationships relevant to this article. Dr Callaghan has disclosed that he is involved in a Pfizer-funded investigator-initiated research study of sickle cell disease; that he is site principal investigator for 4 studies by Genentech and for studies by Sancillo and Global Blood Therapeutics; that he receives honoraria from Bayer, Shire, Novo Nordisk, and Genentech for speaking engagements; that he has participated in advisory boards for Shire, Genentech, Pfizer, Bayer, and Grifols; and that he owns stock in Alnylam. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

Presentation

A 6-year-old boy with sickle cell disease (hemoglobin SS), who is on a long-term exchange transfusion program for repeated splenic sequestration and abnormal transcranial Doppler findings, presents to the emergency department with upper respiratory symptoms and a sore throat. On physical examination he appears well. His temperature is 99.3°F (37.4°C), heart rate is 100 beats/min, respiratory rate is 18 breaths/min, blood pressure is 110/65 mm Hg, and oxygen saturation is 100% on room air. A chest radiograph shows a lesion in the left upper lobe (Fig 1), thought to be round pneumonia, and the child is started on cefepime and azithromycin. It is noted that a very similar lesion was seen on …