Lab Case 76

An 8 year old boy is brought to your ED by his mum. The mum complains that her son has developed a cough and high temperature for the last two days. She also states that he is breathing rapidly and has been off his food.

On examination he is unwell with a few scattered crepitations in his chest.

Vital signs:

BP  90/60

PR  120/min

RR  35/min

T  39 degrees celcius

His blood tests show:

Hb 135  (112-145  g/l)

Plt 270   (140-400)

WCC 7   (4-11)

Neutrophils  4.1  (2-7)

The red cells show moderate cold agglutination. There are several
reactive lymphocytes. Platelet morphology is normal.

CRP  1

Urea and Electrolytes – normal

Questions:

  1. Describe and interpret?
  2. What are the differential diagnosis?
  3. What other tests are indicated?
  4. Give the causes of this condition in the different age groups in children

 

1 thought on “Lab Case 76

  1. 1. fever & tachycardia with respiratory symptoms
    cold agglutinins, reactive lymphocytes
    Hb 135 does not suggest anaemia (need to correlate with clinical volume status)

    2 Mycoplasma pneumonia
    differentials influenza, EBV, lymphoma

    3. CXR, mycoplasma serology
    if there was anaemia: retic count, coomb’s LFT. but I do not perceive indication here.

    4. ?
    mycoplasma common in primary school age
    EBV more common in adolescence
    flu and lymphoma.

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