, Volume 87, Issue 4, pp 331-332
Date: 02 Oct 2007

Hydatid cyst mimicking acute chest syndrome in a sickle thalassemia patient

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Dear Editor,

A 37-year-old sickle-thalassemia β+ male patient presented to our emergency department (ED) with a 10-day history of fever, chills, and acute respiratory symptoms. His symptoms started with high-grade fever (39°C) associated with productive cough, severe bilateral pleuritic pains, and dyspnea. The patient reported having copious sputum expectoration, watery in consistency and whitish in color. His past medical history revealed recurrent hospitalizations, for the past 20 years, with signs and symptoms of acute chest syndrome (ACS) secondary to upper respiratory tract infections. Hydroxyurea maintenance 500 mg twice daily produced a satisfactory decrease in pain crises episodes since 1998.

Physical examination revealed a young man in distress with temperature of 37.2°C, blood pressure of 120/75 mm Hg, pulse of 139/min, and respiratory rate of 24/min, with an oxygen saturation of 93% on room air. Lung examination was significant for decreased breath sounds, crackles, and decrea