CASE HISTORY
Hb 11.5, WCC 4.3, Platelets 50.
Na 136, K 3.4, urea 6.2, creatinine 138.
PT (prothrombin time) >180, APTT (activated partial thromboplastin time) >240, INR 12. Hb 11.5, WCC 4.3, Platelets 50.
Na 136, K 3.4, urea 6.2, creatinine 138. Diagnosis: meningococcal septicaemia.
Bloods sent for FBC, biochemistry, U&E, clotting.
(click for larger graph)
Diagnosis: meningococcal septicaemia.
Bloods sent for FBC, biochemistry, U&E, clotting.
(click for larger graph) Diagnosis: meningococcal septicaemia.
Bloods sent for FBC, glucose, biochemistry, U&E, clotting.
15 year old boy non-specifically unwell for a day. Woke with a widespread purpuric rash and taken straight to hospital.
(click for larger graph)
ED assessment:
Temp 39.0, HR 120, RR 20, BP 90/60.
Alert no meningism; purpuric rash spreading.
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QUESTIONS ON CASE 4
 
Q 8 of 18: Features of severe disease present?
YesNo 
INCORRECT
: Six features of severe disease were present: shock,
absence of meningism, rapidly progressive purpuric rash, low peripheral white blood cell count, thrombocytopenia, and coagulopathy. At least three features of severe disease were present on admission.
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