14 year old girl with fever and swelling of left upper limb and right lower limb k/c/o SCA
25/7/2023. 14 year female child who is k/c/o sickle cell anemia came with c/o fever and swelling of left upper limb and right lower limb associated with pain since 3 days Fever which is of high grade not associated with chills and rigors , cold ,cough, sore throat, chest pain , palpitations,sweating,abdominal pain,vomitings,diarrhoea,decreased urine output . No h/o hematuria , melena,bleeding gums,petechia,menorrhagia . HISTORY OF PRESENTING ILLNESS: Patient was apparently asymptomatic 11 years ago (1/4/2012) when she was 3 years old she was admitted in the hospital with c/o fever , cough, vomitings she was diagnosed to have sickle cell anemia (Hb electrophoresis was done) and was given blood transfusion and treated with Inj ampicillin and folic acid 2. On 23/9/14 She was taken to the hospital with complaints of fever, cough ,cold since 1 week and diagnosed with bronchopneumonia ( chest x ray showed left lower lobe consolidation). She was treated with Inj Augmentin and whole blo