ABSTRACT
A 16-year-old man presented to hospital with shortness of breath, fever and headache. He described initially feeling unwell with flu-like symptoms 6 days earlier. Specifically, he felt feverish with an occasional dry cough, lethargy and general malaise. At the time of presentation he had developed shortness of breath on minimal exertion and had a mild frontal headache. He denied both photophobia and neck stiffness. There was no history of chest pain or palpitations. The patient had sickle cell disease with a sickle beta thalassaemia (HbS – β-thalassaemia) phenotype. He took no regular medications, although he was prescribed penicillin V and folic acid. He attended secondary school and had not travelled abroad over recent years. He denied smoking, alcohol intake or recreational drugs. He was not sexually active.
