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Postgraduate Education Corner: PULMONARY AND CRITICAL CARE PEARLS |

A Patient With Sickle Cell Disease With Septic Shock, Purpura, and Cold Extremities*

Mariam Al-Ansari, MD
Author and Funding Information

*From the Intensive Care Unit, Salmaniya Medical Complex, Ministry of Health, Manama, Kingdom of Bahrain.

Correspondence to: Mariam A. Al-Ansari, MD, Consultant Intensivist, Intensive Care Unit, Salmaniya Medical Complex, Manama, PO Box 12, Kingdom of Bahrain; e-mail: dr_mariam5@hotmail.com



Chest. 2007;131(5):1608-1611. doi:10.1378/chest.06-1748
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A 26-year-old sickle cell disease patient presented to the accident and emergency department with 1-day history of headache, vomiting, and confusion. Cardiopulmonary resuscitation was initiated for unobtainable BP. He was then shifted to the ICU.

A physical examination revealed a cyanotic face with mottled and cool extremities. Confluent satellite cutaneous purpura was present on the hands and feet. Temperature was 38.8°C, heart rate was 140 beats/min, and arterial pressure was 90/45 mm Hg while the patient received high doses of norepinephrine. However, the large arterial pulses of the involved extremities were all normal (Fig 1 ).

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