A 2-year-old Boy with Sickle Cell Anemia

Introduction A 2-year-old boy presented to the pediatric intensive care unit (PICU) for altered mental status. He experienced symptoms of lethargy and decreased activity from a day before admission, along with nausea and vomiting on the day of admission. The review of symptoms was negative for fever, chills, trauma, injury, and recent ingestions or medications.

Medical history : Hb SS, hemophilia B, history of hemarthrosis, previously treated with factor IX Family history : Brother and maternal grandfather with hemophilia Physical examination General appearance : The patient was intubated and sedated. Vital signs:                      Temperature - 99.8°F HR - 191 beats/min Respiratory rate - 18/min BP - 90/61 mm Hg HEENT : Head normocephalic and atraumatic Pupils equal and reactive to light at 3 mm in size bilaterally, no icterus Endotracheal tube in place Cardiac : Regular rate and…