A patient suffering from sickle cell anaemia who presented with the ac
ute chest syndrome is described. The syndrome is reported to he one of
the commonest causes of death in adults suffering from sickle cell di
sease. As it is difficult at presentation to distinguish the syndrome
from infection, it is usual to give treatment appropriate for both. Ea
rly exchange transfusion is thought to limit further damage from sickl
ing and offers the best hope of recovery.