Cor Pulmonale in a Case of Interstitial Fibrosis of the Lungs with Death in a Sickle-Cell Crisis

or exposure to noxious agents. His work in a sugar refinery did not expose him to bagasse dust. Physical examination was recorded as essentially negative except for slight increase in pulse and respiratory rates. Initial laboratory work showed the following: Hemoglobin 12 Gm., red blood cell count 4.2 million, white blood cell count 22,760 with a normal differential count. There was less than 5 per cent sickling in 24 hours. No acid fast bacilli were noted on direct smear of the sputum. An electrocardiogram was normal. Digitalis therapy over the next several weeks gave no improvement. He was admitted to a Veterans Hospital in February 1953 and 8 weeks later was transferred to Charity Hospital for further study. Additional history revealed jaundice of unknown duration at the age of 12 and "rheumatism and tonsillitis " at the age of 13. He was febrile during the latter illness and remained in bed for about 3 months. Physical examination in April 1953 revealed a well developed and nourished Negro