LABORATORY DATA (upon admission to UPMC):
White Blood Cells | 11.3 x 10E+09/L |
Neutrophils | 35 % |
Bands and Immature Forms | 52 % |
Lymphocytes | 10 % |
Hemoglobin | 10.8 g/dL |
Hematocrit | 30.6 % |
Partial Thromboplastim Time | 87.9 sec (nl 20-30) |
Prothrombin Time | 18.1 sec (nl 11.2-14.4) |
Platelets | 58 x 10E+09/L |
Sodium | 134 meq/L |
Potassium | 4.8 meq/L |
Creatinine | 3.6 mg/dl |
Glucose | 51 mg/dl |
Amylase | 249 mg/dl |
DIC Screen | Positive for active DIC |
WBC MORPHOLOGY: Neutrophils contain intracellular bacteria and there is vacuolization of neutrophils and lymphocytes. Atypical lyphocytes are also seen.
URINE: WBCs, RBCs, nitrite, leukocyte esterase, and occasional bacteria present
URINE CULTURE: No growth
GRAM STAIN OF SKIN LESION: Rare gram-positive cocci in pairs and clusters
ICU COURSE:
The patient was given penicillin G, ceftriaxone, and rifampin. Despite maximum support the patient went into electromechanical disassociation and expired approximately 18 hours after initial presentation to the outside hospital.