The truth comes out of children's mouths
Résumé
A 16 year-old patient of Hawaiian ancestry was admitted for confusion in April 2018. He had no relevant past medical history except he went to the dentist few months ago for patchy darkish pigmented macules of the oral mucosa (Fig. 1 A). His mother reported that he complained of pharyngitis and diarrhoea since one week. Blood pressure, body temperature and heart rates at admission were 80/50 mm Hg, 38.3°C and 163 beats per min respectively. Oxygen saturation and glycemia were estimated to 100% room air and 3.2 mmol/L using pulse oximeter and glucometer respectively. The patient did not exhibit neck stiffness, physical examination was normal except localised skin pigmentation disorders (Fig. 1B). Screening of drugs of abuse or alcohol yielded negative results. White blood cells count was increased with left shift (21 000/mm 3 , 68% neutrophils) and haemoglobin level was 15.9g/dL. Platelets count was within normal range and Procalcitonin value was 4.78ng/mL. Blood chemistry results before and after crystalloid fluid resuscitation started immediately after admission, are shown in Fig. 1C. What is the most plausible diagnosis? Q1
Domaines
Sciences du Vivant [q-bio]Origine | Fichiers produits par l'(les) auteur(s) |
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