Case history
Case history #1
A 1-year-old boy presents with sudden-onset fever and vomiting. Findings include irritability, tachycardia, pallor, cold extremities, diffuse skin rash with abdominal petechiae, and signs of meningeal irritation. Blood tests show leukocytosis, markedly decreased platelet count, increased prothrombin time (PT)/partial thromboplastin time (PTT), decreased fibrinogen, elevated fibrin degradation products, elevated urea, and metabolic acidosis. Gram-negative cocci were found in cerebrospinal fluid and meningococci confirmed. Protein C activity is reduced.
Case history #2
A 45-year-old man with acute onset of pancreatitis presents with episodes of epistaxis, increased PT/PTT, and decreased platelet count. Further coagulation work-up reveals increased thrombin time, decreased fibrinogen level, positive D-dimers, and increased fibrin degradation products. The blood culture is negative.
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