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HEMATOLOGY, ONCOLOGY, ALLERGY,

AND IMMUNOLOGY

TREATMENT

■ Exchange transfusionto decrease HbS <30%

LEGULCERS

Commonly found on malleoli

TREATMENT

■ Rest, leg elevation
■ Local wound care

INFECTIONS

■ Sepsis, meningitis, pneumonia, osteomyelitis occur at an increased fre-
quency secondary to functional asplenia. There is increased susceptibility
toencapsulatedorganisms (Haemophilus influenzae, S. pneumoniae).

TREATMENT

■ Low threshold for broad spectrum antibiotics
■ Adhere to immunization schedule.

CHOLELITHIASIS

Bilirubin stoneformation from increased hemolysis

TREATMENT

■ Elective cholecystectomy

OSTEONECROSIS

Typically affects femoral and humeral heads

TREATMENT

■ Analgesics
■ Avoid weight bearing
■ Arthroplasty

PRIAPISM

■ Painful erection secondary to vaso-occlusive crisis

TREATMENT

■ Terbutaline sub-Q
■ Hydration
■ PRBC transfusion
■ Analgesia
■ Urology consultation

Immune-Mediated Hemolytic Anemia

Mediated by antibody formation to antigens on the RBC surface, these
antibody-coated RBCs are partially digested by macrophages in the spleen
(resulting in microspherocytes) and removed from circulation.

Sickle cell patients with

suspected osteomyelitis

should receive antibiotics to

cover for S. aureusand

Salmonella typhi.

Exchange transfusionsare

indicated for sickle cell

patients with cardiopulmonary

collapse, acute CNS event, and

priapism.