Patient history A 25-year-old man was admitted with the diagnosis of a sickle cell pain episode. He was admitted to the hospital six times last year with the same diagnosis and was last discharged two months ago. Again, he presented to the emergency room complaining of abdominal and bilateral lower extremity pain, his usual sites of pain. Physical examination Temperature: 101°F; Respiratory rate: 25 breaths per minute Blood pressure: Normal; Slight tachycardia of 100 bpm Lung examination revealed bronchial breath sounds and egophony in the right lung base.
His oxygen saturation on a 2 L/min nasal cannula was 92%. Besides the usual abdominal and leg pain, he complained of chest pain, which was worse on inspiration. Although he was tender on palpation of his extremities, the remainder of his examination was normal. Laboratory examination Elevated white blood cells and reticulocyte counts…
