Zainab B., 16

Zainab is a 16 year old girl staying with her parents and siblings. She used to be in school but she always falls sick and since been asked to stay at home. Parents are not working but have a small farm for the family. They have a 3 rooms apartment and a pit toilet. They make use of well water, no access electricity in their rural community. Zainab's illness started 2 days with sudden unprovoked throbbing pain in both upper and lower limbs not associated with swelling. Could not sleep at night because of pain. On examination, a 16year old girl but looking much smaller than her age, very ill, but not dyspneic, afebrile, mildly icteric, not acyanosed, palor. The chest, clear and normal heart sounds. There is tenderness around navel. Nil palpable abd organs and bowel sounds heard normal. MSS- Tenderness in right lower limb, She was diagnosed with Vaso-occlusive (Bone) crisis in Sickle Cell Disease (SCD).

Patient’s illness started 2 days with sudden unprovoked throbbing pain in both upper and lower limbs not associated with swelling. Could not sleep at night because of pain. On examination, a 16year old girl but looking much smaller than her age, very ill, but not dyspneic, afebrile, mildly icteric, not acyanosed, palor. The chest, clear and normal heart sounds. There is tenderness around navel. Nil palpable abd organs and bowel sounds heard normal MSS- Tenderness in right lower limb She was diagnosed with Bone crisis in SCD Patient was immediately admitted and commenced treatment with some antimalarials, pain reliefs, IV fluids and other supportive care until patient was stable, patient stayed on admission for six days until she discharged with some orals to be returned for follow up after 1 week. The family are happy, patient is stable again, and they extend gratitude.

Zainab is a know Sickle cell disease patient that presented with features of Vaso-occlusive crisis requiring immediate hospitalization and treatment. Prognosis of bone crisis in sickle cell disease is usually good with prompt pain control, hydration, and treatment of triggers. Zainab's episodes resolved within six days of hospital stay and management. Recurrent crises may cause chronic pain, bone damage, avascular necrosis, infections, reduced mobility, and impaired quality of life over time.