Davina D., 2

Davina is a 2 year old female infant currently staying with her parents, she has a sister. The father is a farmer and the mother is a house wife. They have been struggling to get end means but things have been difficult. They live in a 2 rooms apartment having a pit toilet, a well, no access to electricity and monthly income is 10,000. Davina is a two years old sickle cell female who presented with severe persistent abdominal pain, vomiting and fever for 24 hours. The symptoms started suddenly and has persisted, she has not been able to sleep due to the pain. Whenever she feeds she vomits it and there is associated decrease in urine volume. Symptom started with fever followed by the abdominal pain and vomiting. She is a known sickle cell disease patient with occasional history of bone and finger pains. She is not regular on medications and protection from mosquito bites. On examination, she is febrile with temperature of 39.8oC, pale, abdomen distended with generalized tenderness but normal bowel sound. Malaria test was positive, PCV = 16%. Diagnosis of Sickle Cell Crisis (Abdominal) triggered by Malaria was made.

Davina is a two years old sickle cell female who presented with severe persistent abdominal pain, vomiting and fever for 24 hours. The symptoms started suddenly and has persisted, she has not been able to sleep due to the pain. Whenever she feed, she vomits it and there is associated decrease in urine volume. Symptom started with fever followed by the abdominal pain and vomiting. She is a known sickle cell disease patient with occasional history of bone and finger pains. She is not regular on medications and protection from mosquito bites. On examination, she is febrile with temperature of 39.8oC, pale, abdomen distended with generalized tenderness but normal bowel sound. Treatment was commenced with some injection antibiotics, pain killers, transfusion and other supportive care, patient did well and became stable until discharge, persistent crying stopped. She is to be returned for follow up. The family are so grateful for the medical support. Child is now doing well.

Davina is a known sickle cell disease patient who developed an abdominal Vaso-occlusive crisis likely precipitated by malaria infection. Clinical presentation is consistent with severe pain crisis associated with fever, hemolysis, and dehydration. The combination of a sickle cell crisis and malaria can trigger a life-threatening hyperhemolytic crisis, causing a catastrophic drop in red blood cells and profound anemia. The malaria infection also reduces oxygen levels and accelerates widespread blood vessel blockages, rapidly leading to acute chest syndrome, severe bone pain, and multiple organ failure. Prognosis - is good with prompt diagnosis and treatment, delay in treatment can result to severe complications and possibly death.