USMLE Forums banner

1 - 11 of 11 Posts

·
Registered
Joined
·
4,342 Posts
Discussion Starter #1
A 7 year old child with history of sickle cell disease presented to the ER with widespread petichial rash over the lower limbs and trunk and high grade fever. OE: the child was stuporous and had yellow sclera

Labs showed:

  • WBC 12000 / cubic mm
  • RBC 5 million / cubic mm
  • Hb 7 g/dl
  • Blood film showed microcytosis, hypochromia, and fragmented RBCs
  • Platelets 25000 / cubic mm
  • BUN 55 mg/dl and creatinine 1.6 mg/dl
  • Urine positive for hemoglobin and protein 3+

What is the most likely diagnosis?
a- DIC
b- HUS
c- HSP
e- Meningococcemia
f- Parvovirus B19 infection
 

·
Registered
Joined
·
120 Posts
Don't want to be the odd one out, but i think it's F.

(B19)Fifth disease causing aplastic crisis in a sickle cell patient...:confused: i know the rash is supposed to be "slapped cheek" but there is rash on the rest of their body too....

If not, then my second choice would be HSP...
 

·
Registered
Joined
·
4,342 Posts
Discussion Starter #5
The correct answer

  • In DIC you should see fibrinogen and FDP results in the question and also renal failure and intavascular hemolysis are not characteristic.
  • In HSP you have palpable purpura rather than petichiae and unlikely to see the child in such a disastrous semi comatose status.
  • In meningococcemia you can have all of these but the fragmented RBCs and the hemolysis should point to a more likely diagnosis.
  • In Parvo B19 you have aplastic crisis but you unlikely to see jaundice, hemolysis, and renal failure.
I guess you now know what's the correct answer :)
 
1 - 11 of 11 Posts
Top