A 6-year-old girl with sickle cell anemia, who is well known to ED personnel, presented with URI symptoms for 2 days, and fever to 38.9 (102 F). The URI symptoms consist of a stuffy nose, no rhinorrhea, and a dry cough, which has not interrupted her sleep. Oral intake has been decreased, but adequate. She has been given acetaminophen and over the counter cold medications. She also takes daily prophylactic amoxicillin. Physical Exam : VS T37.7, P 100, R 30, BP 98/52. She is nontoxic appearing.
She has anicteric sclera, clear conjunctiva, mild clear white nasal discharge, a non-injected pharynx and normal TMs. No cough is heard during the exam. Her lungs are clear to auscultation. Her heart is regular without murmurs. Her abdomen is soft and non-tender to palpation. Her spleen in not palpated below the left costal margin, and her liver is palpated 2 cm below the right coastal…
