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Disseminated Intravascular Coagulation

  • Mario V. Fusaro
  • Giora NetzerEmail author
Chapter
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Abstract

A 64-year old woman with a history of non-small cell lung cancer, Type 2 diabetes, and hypertension presented to the emergency department with altered mental status and flank pain. In the emergency department, her initial blood pressure was 83/44 mmHg, with a pulse of 110 beats per minute. On physical examination, she was somnolent but arousable. She had a fine petechial rash on both lower extremities and bleeding from her peripheral IV sites. Laboratory testing results included: white blood cell count of 3100/μL, creatinine of 2.5 mg/dL (her baseline being 1.0), International Normalized Ratio (INR) of 3.1, Partial Thromboplastin Time of 50 s, and platelet count of 33,000 cells/μL. The urine microscopy revealed 20–50 WBC/high-powered field; the urine culture is growing 100,000 colony-forming units of a gram negative bacillus. A computerized tomography (CT) scan of the abdomen and pelvis revealed left hydronephrosis, hydroureter, and perinephric stranding. A slide of the patient’s peripheral blood smear is shown in the Fig. 78.1.

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Copyright information

© This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2020

Authors and Affiliations

  1. 1.Department of MedicineWestchester Medical CenterValhallaUSA
  2. 2.Division of Pulmonary and Critical Care Medicine, Department of Epidemiology and Public HealthUniversity of MarylandBaltimoreUSA

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