Lab Case 209

A 59 year old man returned from a 6 week holiday in the USA 2 days ago. He was seen in an ED while on holiday for shortness of breath and given antibiotics which he completed. The shortness of breath has been ongoing but worse in the last 3 days.

On examination he is short of breath, sweaty and pale.


BP  90/70, HR 120/min, T 38, RR 30/min.

an XR was requested (see Radiology of the week) and blood tests requested.Hb  88

PCV  0.255

Plt  279

WCC  12.8

N  10.8

Na  122 mmol/l

K  7.0 mmol/l

Cl  90 mmol/l

HCO3  7  mmol/l

Urea  76.7  mmol/l

Creat  1222  umol/l

CRP  184

Trop  negative

CK  288

LFT normal

INR  1.8

aPTT  25  (24-34)

Fibrinogen  7.2  (1.6-4 g/l)

D Dimer  8.84  (<0.40)

Describe and interpret his blood tests

Give a differential diagnosis

How would you manage him?