An 18-year-old girl presents with a 2-week history of lethargy and headache. In the last 24 hours, she has also noticed a rash on her arms and feet. She had slightly loose motions two days prior to presentation, but stools were not watery and she did not pass blood or mucus. She has not eaten anything unusual and is not aware of any friends or relatives with diarrhea. Her stool culture did not indicate the presence of any pathogenic micro-organisms, including STEC PCR and STEC serology are negative.
Physical examination The girl is febrile, with a temperature of 38°C and mild jaundice. There is a petechial rash on both forearms and feet. Vital signs: Pulse-95 bpm, BP-150/90 mmHg, JVP- not visible Heart sounds: Normal Chest is clear Abdominal examination showed diffuse tenderness, but no rebound or guarding and no organomegaly. Laboratory investigations Haemoglobin: 7.9 g/dL, MCV: 100,…
