a 27 year old female brought to Ed from outside hospital with complaints of bleeding pv from last 5 days and fever for 3 days..vitals normal,,blood gas ,HB 4.5..rest wnl..GCS E2V2M4..outside repots done same day showing Hb 4.7..platlets 2000.tlc 800...patient in Ed had 2 episodes of seizures...CT brain done....what are the differential diagnosis and how should we proceed for management..

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Young lady presented with vaginal bleeding.Fever developed after 2 days only . It appeared that cause of bleeding ie 2ndary to an underling hematological problem.3 days history of fever is unlikly to produce this much drop in haemoglobin. She has severe thrombocytooenia with Leucopenia TC only 8oo , all indicative of primary hematological problem..Ct showed left frontal ich which is secondary to thrombocytopenia. Ref the case to hematologist urgently.Start antiepileptic med

Intracranial bleed due to thrombocytopenia Manage with de hydrants antiepiletics Find cause of bone marrow suppression Dengue? Urgent ffp and platelet transfusion needed

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TCP/DIC secondary to infections like malaria, leptospirosis or dengue. ??Venous sinus thrombosis

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TCP/DIC Secondary to infection like malaria,lptospirosis, Dengue.

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Rule out CVT pancytopenia , may be risk factor for CVT , get peripheral smear and marrow for cause

Anemia due to bleeding Convulsions due to intraventricular cranial bleed Give ffp platelet transfusion and packed rbc Cover with broad spectrum antibiotic for leukopenia Then work up on cause of leukopenia and thrombocytopenia

Venous hemorrhage Dengue likely

Viral hemorrhagic fever, ,? Dengue shock syndrome. Needs aggressive oru supportive management

Intra cerebral bleed may be due to low platelets

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