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Medical Case Study: M. H. Sickle Cell Disease

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CHIEF COMPLAINT: Stated by the father “M.H. keep complaining of earache and on and off fever”
HISTORY OF PRESENT ILLNESS:
This is a 3-years-old African American male, who presented to the Pediatric Comprehensive Hemoglobinopathy clinic at the University of Michigan C.S. Mott Children's Hospital on 01/25/2017 for a routine follow up visit accompanied by his father. M.H. was diagnosed with Homozygous SS Sickle Cell Disease since birth. Since, his last clinic visit on 7/28/2016, M.H. has been admitted for partial splenectomy in 8/23/2016. Then, in 12/23/2016 his parents brought him to the emergency department in henry ford hospital for mild rhinorrhea, occasional productive cough, temperature of 99 Fahrenheit and pain in his left hand. During
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His course has been complicated by one episode of dactylitis and two episodes of acute splenic sequestration. Therefore, he had a single lumen port placement surgery for chronic transfusion therapy. Also, he had a partial splenectomy in 8/23/2016. Mariano is maintained on Amoxicillin for prevention of further sickle cell complications. The first Acute sickle cell splenic sequestration crisis was in 7/9/2014 that involved Initial Hgb 5.8, PLT count 153, splenic palpation presents 2 finger breadths below the left costal margin. He received two 5 mL/kg antigen matched, leuko reduced packed red blood cell transfusions spaced with a number of hours between transfusions. He was discharged with Hgb of 8.5. The second splenic sequestration crisis was in 8/14/2014 with initial Hgb 5.0, PLT count 62 and the spleen was palpable 3 cm below the left costal margin. He received 1 packed red blood cell transfusion. Upon discharge Hgb 7.5 and the spleen tip was not palpable. In 12/6/2015 he was admitted to the hematology unit for three days due to fever 102, positive culture of Rhinovirus and viridans group streptococci, and right leg pain crisis. In 11/17/2015 he was admitted for 2 days for fever of 101, but blood cultures and chest X-ray were negative. Ultimately, in 8/23/2016 when he became 3-year-old, he had a partial splenectomy. He is maintained on Amoxicillin for prevention of further sickle cell
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