Acute Chest Syndrome and Critical Illness-Associated Cerebral Microbleeds in Sickle Cell Disease: A Case Report

A 33-year-old woman with sickle cell disease presented with severe lumbar pain. Initially stable, she experienced rapid deterioration within the first 24 hours, developing respiratory failure, fever, and impaired consciousness. Chest imaging revealed extensive bilateral infiltrates, and laboratory tests showed severe anemia, thrombocytopenia, and elevated inflammatory markers. She required mechanical ventilation, exchange transfusions, and antibiotics. Parvovirus B19 infection was confirmed. After nine days, she improved, but neurological recovery was delayed. Magnetic resonance imaging revealed cerebral microhemorrhages consistent with critical illness-associated cerebral microbleeds. She was discharged after a 34-day hospitalization. This case highlights two severe and potentially life-threatening complications of sickle cell disease, namely acute chest syndrome and critical illness-associated cerebral microbleeds, underscoring the importance of early recognition and aggressive management.