Topic: blood clotting
a 19 year-old female patient refers 39 °c afternoon fever 10 days befo...
Topic: blood clotting
a 19 year-old female patient refers 39 °c afternoon fever 10 days before , accompanied by sweats and chills, throat pain. five days later she presented epistaxis, gum bleeding and purpur spots on the legs, bilateral neck adenopathies..
physical examination: t39’c bp 110/70 mm hg hr 100bpm good general appearance. skin reveals a purpuric petechial exanthem mainly in lower extremities and milder in chest and abdomen. erythematous oropharynx, hypertrophic tonsils and few white plaques. bilateral cervical firm 0.5 fo 1 cm adenopathies were present . abdomen with 1.5 cm smooth painless hepatomegaly and 2cm splenomegaly. rest of the examination unremarkable.
lab> hb 14 g/l, hct 44 %, leukocytes 13 500 x 10-9/l, neutrophils 25% lymphocytes 61% monocytes 14 % , peripheral blood smear revealed abundant lymphomonocytes, increased esr. glycemia, uric acid, fhp, renal and pancreatic tests were unremarkable. total protein: 8.8 g%; albumin 60 %; alfa 1 5 %, alfa 2 12 %; beta 14 %; gammaglobulins 16 %. bleeding time 2min, clotting time 8min, prothrombin time c–14 t –15, partial tromboplastine time 42seg, platelettes : 40 000 x 10-3 /l; clot retraction: null. ana, cryoglobulin, inmmunecomplex and complement normal. paul–bunnell–davison positive 1/364. indirect inmmunofluorescence for epstein barr capside positive 1/728 for ig g and igm. bone marrow smear revealed hyperelularity megakariocytes mildly elevated in number some bizarre and immature.
what is the diagnosis and what is the disease?
name what organs are affected.
Answers: 3
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