30th September 2021

A 19-year-old male is brought in by ambulance after collapsing

A 19-year-old male is brought in by ambulance after collapsing. A collateral history reveals he had been experiencing a fever for 3 days, though it had subsided that morning, as well as epistaxis. An examination reveals widespread flushing, with islands of normal skin. Whilst waiting in the department, his skin becomes cold and clammy. Observations demonstrate tachycardia, hypotension, and a narrow pulse pressure. Initial blood tests indicate a raised haematocrit, thrombocytopenia, and hypoalbuminaemia.

Which of the following is the most likely underlying diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.