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Acute Chest Syndrome

Grumbo RG - MedPix (2008)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Acute Chest Syndrome

History: 13 y/o female who presented to the ER shortly after onset of sore throat, cough and central sternal chest pain. The pain was central sternal, sharp, and worse with cough and deep inspiration. On arrival to ER she was febrile to 102.1 with O2 sat 93% on RA. She was placed on 2L O2 by NC with sats rising to 99-100%. On the day prior to admission, she received Hep A, HPV, varicella and flu vaccinations.

Findings: Initial PA/Lat showed an enlarged cardiac silhouette. Prominent pulmonary vasculature and basilar increased interstitial markings and bilateral small pleural effusions. Also noted are a surgical clip in the right upper quadrant and absence of the spleen shadow. No osseous abnormalities are ntoed. Follow-up portable radioagraph obtained after marked worsening of clinical status revealed new large bilateral effusions and evidence of bilateral lower and right middle lobe air space disease.

Ddx: Acute chest syndrome Bacterial pneumonia Viral pneumomina

Dxhow: Confirmed by clinical history and course

Exam: VS Temp(c) 99.1, temp(max) 102.1, BP 124/134, HR 75, O2 95% on 2L nc Gen: Well developed thin girl in NAD heent: perrla, normal cv: 2/6 systolic ejection murmur heard at left sternal border lungs: rales bibasilar; decreased air movement. abd: soft ntnd ext: no clubbing, cyanosis, or edema. Labs: CBC: 13.9>9.2/25.4<243 (stable H and H) BMP: 138/4.2-106/23-6/0.65<112

No MeSH data available.


The cardiac silhouette is enlarged. There is opacity in the posterior costophrenic angle with silhouetting of the posterior aspects of both hemidiaphragms consistent with pleural effusions. No abnormality of the vertebral bodies is noted.
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MPX1166_synpic41472: The cardiac silhouette is enlarged. There is opacity in the posterior costophrenic angle with silhouetting of the posterior aspects of both hemidiaphragms consistent with pleural effusions. No abnormality of the vertebral bodies is noted.


Acute Chest Syndrome

Grumbo RG - MedPix (2008)

The cardiac silhouette is enlarged. There is opacity in the posterior costophrenic angle with silhouetting of the posterior aspects of both hemidiaphragms consistent with pleural effusions. No abnormality of the vertebral bodies is noted.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1166&req=5

MPX1166_synpic41472: The cardiac silhouette is enlarged. There is opacity in the posterior costophrenic angle with silhouetting of the posterior aspects of both hemidiaphragms consistent with pleural effusions. No abnormality of the vertebral bodies is noted.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Acute Chest Syndrome

History: 13 y/o female who presented to the ER shortly after onset of sore throat, cough and central sternal chest pain. The pain was central sternal, sharp, and worse with cough and deep inspiration. On arrival to ER she was febrile to 102.1 with O2 sat 93% on RA. She was placed on 2L O2 by NC with sats rising to 99-100%. On the day prior to admission, she received Hep A, HPV, varicella and flu vaccinations.

Findings: Initial PA/Lat showed an enlarged cardiac silhouette. Prominent pulmonary vasculature and basilar increased interstitial markings and bilateral small pleural effusions. Also noted are a surgical clip in the right upper quadrant and absence of the spleen shadow. No osseous abnormalities are ntoed. Follow-up portable radioagraph obtained after marked worsening of clinical status revealed new large bilateral effusions and evidence of bilateral lower and right middle lobe air space disease.

Ddx: Acute chest syndrome Bacterial pneumonia Viral pneumomina

Dxhow: Confirmed by clinical history and course

Exam: VS Temp(c) 99.1, temp(max) 102.1, BP 124/134, HR 75, O2 95% on 2L nc Gen: Well developed thin girl in NAD heent: perrla, normal cv: 2/6 systolic ejection murmur heard at left sternal border lungs: rales bibasilar; decreased air movement. abd: soft ntnd ext: no clubbing, cyanosis, or edema. Labs: CBC: 13.9>9.2/25.4<243 (stable H and H) BMP: 138/4.2-106/23-6/0.65<112

No MeSH data available.