A 12-year-old girl with hemoglobin SS disease presents with fever, cough with sputum production, chest pain, right shoulder pain, bilateral leg pain and decreased appetite before the coronavirus disease 2019 pandemic. She had a 2-day admission 1 week earlier for acute chest syndrome, her second hospitalization in 12 months. She received intravenous (IV) ceftriaxone and azithromycin but no blood products and was discharged on 5 more days of amoxicillin and 3 more days of azithromycin after resolution of her symptoms of fever, cough, chest pain, right shoulder pain, and decreased appetite. She now reports that her symptoms have been persistent since this most recent discharge despite the antibiotic treatment. The cough has been worsening, and the bilateral leg pain is new compared with her symptoms during the most recent hospitalization. She denies vomiting, diarrhea, abdominal pain, rashes, headache, or vision changes. It is influenza season, but she has no known sick contacts and no exposures to zoonotic hosts, and she lives in an urban area in the northern Midwest.
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