Discussions By Condition: I cannot get a diagnosis.

19 male with bloody diarrhea

Posted In: I cannot get a diagnosis. 0 Replies
  • Posted By: donnymagno
  • September 13, 2008
  • 06:05 PM

19 year old male
presenting with fever, melena, worsening oliguria
with pallor, nausea, abdominal pain, agitation

Hemoglobin 90 --> 62
platelet 237 --> 22
WBC 30 (seg 53 lymp 35)
PBS: echinocytes, leukoerythroblastosis

prolonged PT and PTT

Creatinine 1100
underwent emergency hemodialysis
rapid hepa screen: negative
post HD crea 1300

normal initial bilirubins

aminotransferases drastically shoot up
AST 130 --> 32000
ALT 40 --> 9000
LDH 23000

chest xray: suggestive of pulmonary hypoplasia

kidney ultrasound: bilaterally small 5 cm and 6 cm

still no stool or blood culture result

underwent pRBC transfusion
received antibiotics
developed rapidly decreasing sensorium
then eventually expired after ACLS

What is the most likely diagnosis and what are the plausible differentials?

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