Hyperbilirubinemia to predominance of the direct one, hiperamilasemia, transaminasemia, phostatase alkaline raised, hipokalemia, time of long prothrombin, normochromic anemia, thrombocytopenia, leukocytosis, neutrophilia,
bandemia, high CPK, azotemia, proteinuria, hematuria, blood culture and urine culture of revenue negatives, arterial gas with hypoxemia and desaturation, kirby's index under, short circuits intrapulmonary and the difference alveolar-arterial of oxygen raised.
These criteria included a heart rate greater than 90 beats per minute, a breathing rate greater than 20 breaths per minute, a body temperature greater than 38 degrees or less than 36 degrees Celsius, and a white blood cell count greater than 1200/mm or
bandemia greater than 10 percent.
Laboratories were remarkable for leukocytosis (14.3Thou/uL), neutrophilia (86%),
bandemia (7%), high anion gap metabolic acidosis (31 mEq/L), hyperglycemia (484 mg/dL) with large blood ketones, and elevated creatinine phosphokinase (2227U/L) and creatinine (3.45mg/dL) levels.
Multivariate analysis revealed that the development of bacteremia was associated with a higher mortality rate (adjusted odds ratio [OR] 9.7; 95% CI: 1.9-50.6, p=0.007), while shock and
bandemia were associated with the development of bacteremia (adjusted OR 5.3; 95% CI: 2.3-12.7, p<0.0001 and adjusted OR 4.0; 95% CI: 1.6-9.9, p=0.0003, respectively).
Because of hypotension,
bandemia, and lactic acidosis, he was admitted to the Intensive Care Unit for further monitoring.
His laboratory data demonstrated no evidence of infection with a white blood cell count of 5.9 k/[micro]l without
bandemia. Remaining complete blood count values included hemoglobin of 17.5 gm/dl and a platelet count of 441 k/[micro]l.
The patient was noted to have a leukocytosis with
bandemia, fever, and tachycardia suspicious for sepsis.
Significant laboratory studies included an elevated leukocyte count of 18,400/ [mm.sup.3] without a
bandemia. Blood cultures were drawn and she was started on broad spectrum antibiotics.
* The positive predictive value of CRP as a septic screen parameter (5) was 68.93% and that of
Bandemia positive cases was 70.08%, but when both these parameters was considered together the positive predictive value increased to 71.46 %.
Entre los examenes diagnosticos patologicos se reporta: trombocitopenia leve, anemia, leucocitosis sin neutrofilia ni
bandemia, hiperbilirrubinemia a expensas de bilirrubina indirecta, elevacion de creatinina para la edad, reactantes de fase aguda levemente elevados, hiperglicemia, hipocalcemia, radiografia de torax en donde se insinuan infiltrados granulares en hemitorax izquierdo sin consolidacion con silueta cardiotimica aumentada de tamano; ecocardiograma con evidencia de miocardiopatia hipertrofica biventricular, disfuncion diastolicabiventricular, ductus arterioso persistente restrictivo y foramen oval restrictivo; la ecografia renal y de vias urinarias reporta rinones hiperecoicos con mala diferenciacion cortico-medular, de tamano normal sin signos de nefrocalcinosis.
Los paraclinicos de ingreso mostraron Leucocitosis (17,820/[mm.sup.3]) a expensas de neutrofilia (79%),
bandemia importante (11%), sin anemia (Hb 13.8 g/dL), plaquetas normales (281.000/[mm.sup.3]), los reactantes de fase aguda estaban elevados (proteina C reactiva de 94 mg/L).
She had no leukocytosis or
bandemia, and immunosuppression was continued as mentioned above.
