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							CASE HISTORY
														
							
							
							
									Hb 11.5, WCC 4.3, Platelets 50. 
Na 136, K 3.4, urea 6.2, creatinine 138. 
PT (prothrombin time) >180, APTT (activated partial thromboplastin  time) >240, INR 12. 
Ca 2.1, Mg 0.4
 
   (click for larger graph)
 Hb 11.5, WCC 4.3, Platelets 50. 
Na 136, K 3.4, urea 6.2, creatinine 138. 
PT (prothrombin time) >180, APTT (activated partial thromboplastin  time) >240, INR 12. Hb 11.5, WCC 4.3, Platelets 50. 
Na 136, K 3.4, urea 6.2, creatinine 138. Diagnosis: meningococcal septicaemia. Bloods sent for FBC, biochemistry, U&E, clotting. 
    (click for larger graph) 
Diagnosis: meningococcal septicaemia. Bloods sent for FBC, biochemistry, U&E, clotting. 
    (click for larger graph) Diagnosis: meningococcal septicaemia. Bloods sent for FBC, glucose, biochemistry, U&E, clotting. 
15 year old  boy  non-specifically unwell for a day.  Woke  with a widespread purpuric rash and taken straight to hospital. 
       (click for larger graph) 
ED assessment: Temp 39.0, HR 120, RR 20, BP 90/60.
 
  Alert no meningism; purpuric  rash spreading.  
 									
							
							
							 
						
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								QUESTIONS ON CASE 4
								  
								
																
								
								      								
								
								Q 10 of 18: Treatment fast enough?  Aggressive enough?
  
										
							  YesNo		
									
							
							 									
									
		
									  	
									  
								
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