Case of the Week: 29th October

October 29, 2018

Here we have a recent case from volunteer Dr Anna demonstrating how HIPZ support results in the the successful management of Sickle Cell Anaemia at Makunduchi Hospital:

 

At the moment we are facing quite busy times at our OPD in Makunduchi.  Therefore it is of special importance that our triage systems is working well and very sick patients presenting with alarm symptoms such as high fever, altered breathing or altered consciousness can be filtered out from the waiting crowd and treated as soon as possible.

This time my colleague working in the OPD quickly sent us a child to the ward for admission and further treatment.  The little boy was about 9 months old and a known case of sickle cell anaemia. He had been deteriorating for about 2 days, having developed a fever, pain in his joints and become very weak.  

 

When my local colleagues and I saw the little one on the ward, he was stable, but really weak and pale.  A laboratory testing for his Hb-level revealed a severe anaemia with an Hb-level of 4mmol/l (normal is greater than 10mmol/l).  All other tests, notably a blood smear for malaria, were negative. His blood sugar levels were in normal range.

 

Considering his background, we knew now that he was suffering from a sickle cell crisis that had been precipitated by an infection. Because of his low Hb-level, we decided to give him a blood transfusion.

 

On the ward we put a drip in his hand, treated the infection with antibiotics and gave him medication to lower the fever.  In the meantime the Makunduchi laboratory prepared everything for the transfusion. They did the blood grouping and cross-matching - luckily they had enough blood for children available.

 

After his fever had lowered, we could transfuse him the first unit of 100ml packed red cells. He tolerated the transfusion without any complications, so that he could receive a second dose on the next morning.  

 

In the following time he clinically improved quickly from day to day.  We finished his antibiotic treatment and could sent him home in very good condition

 

We hope to see the patient and his mother next week again for follow up in our paediatric clinic.

 

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