A female 35 yrs old was admitted with complaints of pain Right Iliac Fossa since 7 days in some private nursing home was given treatment for the same but after treatment sge developed severe hemorrhagic lesions , bleeding from nose and mucosal surfaces and eruptions throughout the body....No documentation of the treatment she received could be retrieved....She developed Severe Pancytopenia....Discuss the cause and approach to this patient....



D/D since she is in septicemia rule out DIC 2 drug induced bone marrow depression with pancytopenia If the pt is in shock first stablise the pt by iv fluids or BT or lpasama replacement yes cause of acut condition to be treated surgically once pt becomes normal

C/O ac.abdomen due to perforated appendix with thrombocytopenia, anemia,septecaemia immediate hospitalisation in higher centers preoperative evaluation & blood as well as platelets if needed must be given cause of hemrragic lesion must be find out under hematologist consult & treated for operative procedure take surgeon's consult

Apprndicular perforation with septicaemia with thrombocytopenia. With coagulopathy adv appendicectomy after platlets are adequate and haemodynamically fit.before surgery see creatinine also and give ffp 2 vac tds

CAN SUSPECT TEN &should rule out for hiv

Can you give more info regarding the rx she received in the other hospital and her initial presentation? Was a PS ordered ?

Dts wt we wanted to see ...but unfortunately it was done in a remote village..

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Dress syndrome. Sepsis. Do Usg abd. Start broad spectrum antibiotic after test dose. Steroids and antihistamines

Better to manage the patient conservatively at first and then to advise interval appendectomy.

I think.ffp transfusion .wholefresh blood transfusion.neded inj.vit k .also

Asenjo carcinoma of large bowelofilepcecalrgn. Leukaemia

Septicemia and thrombocytopenia and anemia Rx phosphorus 0/1 2hrs only

Acute appendicular perforation with septicemia with thrombopenia

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