Lab Case 76

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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

 

One 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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