Homozygous Sickle Cell Disease in Medicine / Internal Medicine — 23yo Man | Hematology | SMLE Q#11746

SMLE Question #11746

Medicine / Internal Medicine Hematology

Objective: OBJ-101

Last updated: February 2026
A 23-year-old man with homozygous sickle cell disease (HbSS) presents to the emergency department with 2 days of fever, pleuritic chest pain, and worsening shortness of breath. He has a nonproductive cough and chest tightness. Examination shows decreased breath sounds with scattered bilateral crackles. Chest X-ray shows new bilateral patchy infiltrates. He has received IV broad-spectrum antibiotics, IV fluids, supplemental oxygen, and analgesia, but his hypoxemia persists and his respiratory status is worsening. What is the most appropriate next step in management?

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