An 18-year-old girl presented with a two-week history of lethargy and headache. In the last 24 hours, she had also noticed rashes on her arms and feet. On examination, she was febrile with a temperature of 38 °C and looked mildly jaundiced. There was a petechial rash on both forearms and feet. Physical examination Pulse: 95 bpm BP: 150/90mmHg JVP not visible Normal heart sounds Chest clear Abdominal examination showed diffuse tenderness but no rebound or guarding and no organomegaly.
Laboratory investigations Urine dipstick showed protein ++, blood +++, negative for leucocytes, nitrites, and glucose. ECG and CXR: Normal Bilirubin: 57 μmol/L but otherwise normal LFT Reticulocytes: 5% (elevated) Haptoglobin: Low Blood film: Fragmented red cells Coombs test: Negative What is the most likely diagnosis? *This case is from the Docplexus editorial team for educative purposes only. Source:…
