Case study (13)- Systemic sepsis and a mild macrocytic, normochromic anemia
History
The 75-year-old female patient with cancer presented at the hospital with symptoms of general sickness and unproductive cough.
Laboratory Investigations:
1. CBC:
RBC:3.62 X 106/μL (4-5.5 X 106/μL)
HGB: 115 g/dL (120-174 g/dL)
HCT: 36.8 % (36-52%)
MCV: 101.8 fL (76–96 fL)
MCH: 31.8 pg (27-32 pg)
MCHC: 312 g/L (300-350 g/L)
RDWsd:46.6 fL (20-42 fL)
RDWcv: 14.3 % (0-16 %)
WBC: 28 X103/ μL (5–10 X 103/ μL)
Neutrophils: 26.18 X 103/μL (2-7.5 X 103/μL)
Lymphocytes: 1.23 X 103/μL (1.08–3.17 X 103/μL)
Monocytes: 0.45 X 103/μL (0.15-0.7 X 103/μL)
Eosinophils: 0.06 X 103/μL (0-0.5 X 103/μL)
Basophils: 0.08 X 103/μL (0-0.15 X 103/μL)
Neutrophils %: 93.5 % (40-75 %)
Lymphocytes %: 4.4 % (14.76-45.4 %)
Monocytes %: 1.6 % (3-7 %)
Eosinophils %: 0.2 % (0-5 %)
Basophils %: 0.3 % (0-1.5 %)
PLT: 240 X 103/μL (150-400 X 103/μL)
Peripheral blood smear
2. Other laboratory findings
- Other abnormal clinical laboratory results include elevated CRP levels (165 mg/L [ref.range: 0 -5 mg/L) and lower than normal iron levels (3.3 [6.6 – 26.0 μmol/L).
- Urinalysis excluded renal and urinary tract infections.
- Blood culture was not obtained as antibiotics were already administered.
- The findings of the physical exam and chest X-ray are characteristic of lobar pneumonia.
Diagnosis
Systemic sepsis and a mild macrocytic, normochromic anemia
Disease course
- Despite the extensive antimicrobial therapy, the patient’s status deteriorated. The patient was transferred to the Intensive Care Unit, but she expired three days later.
- Systemic sepsis and a mild macrocytic, normochromic anemia History The 75-year-old female patient with cancer presented…){kind=link}
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