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  #1  
Old 03-03-2010
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Blood Leukemia with black lesions!

A 21 year old male with ALL presented with fever and several dark colored skin lesions that started 2 hours ago. He was given his chemotherapy pulse 10 day ago. He appeared lethargic and had a temperature of 39C (102.2F). PR 110, RR 32, BP 90/50. Physical examination showed black papular rounded skin lesions on the lower extremities surrounded by an erythematous rim. His leukocytes count was 1000/mm (8% neutrophils and 90% lymphocytes). Blood culture grew Gram negative rods. Which of the following is most likely responsible for this patient's hypotension?

A- Bradykinin causing increased capillary oncotic pressure
B- Increased serum concentrations of C8 and C9 causing rise of histamin release from basophils and mast cells.
C- Lipopolysaccharide stimulating production of tumor necrosis factor.
D- Lipoteichoic acid stimulating production of Interleukin 1.
E- Skin macrophage activation releasing inflammatory mediators.
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Old 03-03-2010
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Default LPS

lipopolysacharides on the cell wall mediate the release of tnfs n cause hypotension due to endotoxic shock..other characters inc increased respiratory rate, fever etc
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Old 09-25-2010
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Why Lymphocytes and not neutrophils does anyone know?
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Old 09-25-2010
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Quote:
Originally Posted by ashishkabir View Post
Why Lymphocytes and not neutrophils does anyone know?
because he has ALL
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Old 09-25-2010
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C- Lipopolysaccharide stimulating production of tumor necrosis factor.
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  #6  
Old 09-26-2010
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yes it should be

C- LPS production of tumor necrosis factor. as in endotoxic shock
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  #7  
Old 09-26-2010
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That's true - I'm going selectively blind
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Originally Posted by Androide89 View Post
because he has ALL
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Old 09-26-2010
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Listening Pseudomonas

Yes, LPS most probably working with Haemolysin sort of exotoxin.

Causative organism most probably Pseudomonas. Septicemias (Fever, shock +/- skin lesions (black, necrotic center, erythematous margin, ecthyma gangrenosum).
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