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25th July 2024
A 32-year-old female presents to A&E with her partner after a few days of worsening intermittent confusion
A 32-year-old female presents to A&E with her partner after a few days of worsening intermittent confusion and fevers. She reports abdominal pain but is unable to give a clear history. She has no known past medical history.
On examination, she has a petechial rash across her arms and abdomen and conjunctival pallor. Observations show a temperature of 38.2oC, HR 93 bpm, BP 148/78 mmHg, RR (respiratory rate) 18/minute and sats 97% room air.
Bloods are as follows:
| Hb (115 – 165 g/L) | 95 g/L |
| WCC (3.6 – 11.0 x 10⁹/L) | 13.7 x10⁹/L |
| Platelets (140 – 400 x10⁹/L) | 12 x10⁹/L |
| Bilirubin (<21 μmol/L) | 46 µmol/L |
| Urea (2.5 – 7.8 mmol/L) | 9.8 mmol/L |
| Creatinine (45–84 μmol/L) | 155 µmol/L |
| CRP (< 5mg/L) | 11 mg/L |
| Film | Red cell fragments seen |
What is the most likely diagnosis?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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