hi we have a 23 dayes new born that admitted in our hospital by fever ,cough, dyspnea, and in lab data he had low plt(45000)+ anemia(Hb<9) and leuckopenia.he has splenomegalia,mild cardiac mur mur, but other Px was normal.TORCH study was normal (,we have dident performed BMA by know)
,and LP was performed that it was normal too! CXR had reticulonoduler pattern(viral pneumonia)
ESR was 41 CRP was+++ and other test that you can consider it was normal!
B/C was normal .
vancomycin and cefotaxim was started by late onset sepsis diagnosis.by no increase in Plt and Hb we started Plt and Hb but recurrently Plt and Hb decreased ,we infused IVIG 2gr/Kg,in 2 days but no increase occured.so i think we must perform BMA,may be an underlying disease is present ,Like Evans snydrom,unfortunatly he was not my direct patient and his attendant dident examed Retic count,coombs -i have sent his PBS for a pediatric hematologist ,
it is not ready just know-What do u think?