Sudden exertional death in a soldier with sickle cell trait

Most family physicians regard sickle cell trait (SCT) as a benign condition. But in special circumstances SCT can have deadly consequences. SCT affects 8% of the black population. Most of the cases of sudden exertional death (SED) in those with SCT have occurred during military basic training. A retrospective review of all soldiers in basic training found that those with SCT had a 40-fold increased risk of SED. This paper discusses an individual case of SED that occurred at Fort Sill, Oklahoma. A literature review makes comparisons to our index case. The current Army Medical Corps recommendations for prevention of SED as well as the current military SCT screening policy will be discussed. Prospective studies are needed to evaluate the efficacy of the currently recommended preventative guidelines as well as to more fully evaluate the potential for SCT to cause significant morbidity and mortality during military basic training.