Pattern of pulmonary manifestations in patients with sickle cell disease and Fever

The objective of this study was to determine the frequency and pattern of pulmonary manifestations in febrile patients with sickle-cell disease (SCD), a condition prevalent in the Eastern Province of Saudi Arabia.

The main pulmonary complications in febrile adult SCD patients were studied between January 1986 and December 1990.

The medical records, chest X-rays and microbiological data of all febrile (temperature >38°C) SCD patients >12 years of age admitted to KFHU during the study period were retrospectively reviewed.

Of the 164 patient-episodes in 49 male and 19 female SCD patients, chest X-rays were abnormal in 33 (20.1%) episodes. Of these 33, there was consolidation in 17 (52%), pleural effusion in 6 (18%), pleural effusion and consolidation in 4 (12%), consolidation with collapse in 3 (9%), pleural thickening in 2 (6%) and bronchogenic carcinoma in one.

Pneumonia was the most common complication in Saudi SCD patients with abnormal chest X-rays. Chest X-rays are most useful in SCD patients with symptoms of chest infection, abnormal chest signs, or those with persistent fever during vaso-occlusive crisis.