A 19-year-old previously healthy woman has had mild pharyngitis followed by a high fever over the past 24 hours. When seen in the emergency room, her skin shows extensive areas of purpura. Vital signs include:

- Temperature: 39°C
- Pulse rate: 102/minute
- Respiratory rate: 21/minute
- Blood pressure: 80/55 mm Hg

Laboratory studies show:

- Serum sodium: 115 mmol/L
- Potassium: 5.3 mmol/L
- Chloride: 92 mmol/L
- CO2: 22 mmol/L
- Glucose: 2.3 mmol/L
- Creatinine: 97.3 µmol/L

Which of the following is the most likely diagnosis?

A) Idiopathic adrenalitis
B) Disseminated tuberculosis
C) Reactive systemic amyloidosis
D) Sheehan syndrome
E) Meningococcemia
F) Hemochromatosis

The most likely diagnosis for this patient is Meningococcemia, a bacterial infection caused by Neisseria meningitidis that can lead to severe sepsis and disseminated intravascular coagulation (DIC).

Explanation:

The most likely diagnosis for this patient is Meningococcemia. Meningococcemia is a bacterial infection caused by the bacteria Neisseria meningitidis, which can lead to severe sepsis and disseminated intravascular coagulation (DIC). The high fever, extensive areas of purpura on the skin, and low blood pressure are all consistent with this diagnosis.

Meningococcemia, also known as meningococcal septicemia or sepsis, is a severe and potentially life-threatening bacterial infection caused by the bacterium Neisseria meningitidis. This bacterium is one of the leading causes of bacterial meningitis (inflammation of the protective membranes surrounding the brain and spinal cord) and can also cause bloodstream infections, leading to septicemia.

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wazzuhasaeed17 wazzuhasaeed17 · Answer 2 · 2024-10-28T21:00:06-04:00

Final answer:

The diagnosis for the 19-year-old woman with symptoms of high fever, purpura, and abnormal vital signs and lab tests is most likely Meningococcemia. The correct option is E) Meningococcemia.

Explanation:

The symptoms mentioned in the query, such as high fever, purpura on the skin, abnormal vital signs and laboratory findings, are indicative of Meningococcemia. Meningococcemia is a severe illness characterized by rapid onset of hemorrhagic eruptions on the skin, fever, hypotension, septicemia, and meningitis. The key indicators include sudden high fever and pinpoint rash, later evolving into purpura.

The notable findings including lowered blood pressure, increased pulse rate, and abnormal serum sodium levels, also point towards this condition. Please consult a healthcare professional for actual diagnosis and treatment. Hence, E is the correct option.

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