Mary J., 5

Mary Juliet is a 5-year-old girl living with both her parents and attending PP1. She enjoys singing, going to church, and eating chapati with beans. Her mother is a peasant farmer earning about KSh 1,500 per month, which barely meets the family's daily needs. Mary was brought to the health facility after developing painful swelling behind her right knee that had persisted for one week. She also experienced recurrent episodes of fever, severe joint pain, and increasing difficulty walking because of the pain. Following clinical assessment, laboratory investigations confirmed sickle cell disease, while an ultrasound revealed a right popliteal (knee) cyst. She was also diagnosed with sepsis. The surgical team reviewed the cyst and determined that immediate surgery was not required. Mary was started on appropriate treatment, and her parents received counselling on sickle cell disease, including how to recognize and manage painful crises and the importance of regular follow-up to prevent complications.

Mary has been diagnosed with sickle cell disease, sepsis, and a right popliteal cyst. She has been started on appropriate antibiotics, pain management, hydration, and supportive care, while the knee cyst is being managed conservatively as surgery is not urgently required. With prompt treatment, the infection is expected to resolve, and her prognosis is favourable. However, sickle cell disease is a lifelong condition requiring regular follow-up, preventive care, and adherence to treatment to reduce painful crises, infections, and long-term complications.