A young female aged 18 yrs presented with history of Fever with chills , breathlessness since 5-6 days and altered sensorium since 1 day.....On taking history from attendants, it was revealed that She has had 2-3 episodes of Jaundice in last 2 yrs and 3 PRBC transfusions were also done 8 months back due to severe anemia....She was foundto have clubbing...Discuss this interesting case and possible differentials...

a 19 year girl was admitted in fmw with complains of fever with chills and rigor abdominal pain loose motion on examination pallor hepatosplenomegaly was present past history of same complains was present three to four times with in 6 month past history of pcod. severe hypomenorrhoea and 2 BT WAS DONE. I POSTED present cbc findings ps blood image and sickling test images......may be useful and rare to find intresting case.....give ur expert opinion thanks

3 months Old ; Peripheral Smear Hb - 4.4 gm/ dl TLC - 14,400 / Cumm Platelets - 80,000/cumm

Interesting case: 3 months, Nepali child, non consanguinous no adverse perinatal event, term, AFD,male presented with Progressive pallor 1 month No fever, jaundice, bleeding Exclusively breast fed (mother appropriate age, no pallor, on mixed diet) Examination: Stable vitals except tachycardia Pallor present No Icterus, Edema Liver 4 cm Spleen 6 cm Hb: 6.1 Platelets: 1.3 lacs TLC: 8000 Peripheral smear outside: anisocytosis with pred. normocytic to macrocytic RBCs with few macrovalocytes, slightly reduced platelets MCV of mother : 72 MCV of father : 78 Repeat Peripheral smear and DCT and B12 Level given. What are your differentials????

32yr female.. Sepsis and unconscious state.. Peripheral smear to comment