Question

Natasha was certain she was looking younger despite her 58 years on this Earth. Every day in the mirror her lines seemed to disappear. She had searched so long for something to slow the process of aging; her marriage depended on it! Vladimir would never stay with her if he saw the wrinkles she did! Even her precious parrot, Bruno, had noticed and shied away from her! She could never live without him so she tried it all: mercury creams, Botox, weight pills from the ancient woman in the south side market of Moscow, Switzerland’s best cell therapy, and one pint of honey and another of yogurt every day!

But a week or two after her “youth” came back she wasn’t feeling nearly so good…. Finally she went to the hospital because her fever was so high (102.8). She also had a non-stop horrible cough, muscle aches, vomiting, diarrhea, and a terrible headache. As the attendant physician at the hospital you try to narrow it down based on the patient profile, potential exposures and symptoms.

What are the top five suspects for Natasha’s infectious disease? Justify your choices.

You send off for some laboratory tests right away and find the information below. Explain these results. Does this change your diagnosis? If so how?

Leukocytes – 6,000,000,000/L

Platelets – 700,000/ L

RBC – 450,000,000/L

Hb – 14g/dL

HCT% - 49

Bilirubin – 6 mg/dL

Creatinine – 0.97 mg/dL

Answer 1

The leukocytes are increased in tremendous amounts, it could be Leukemia. It could be myelo proliferative leukemia since all the blood cells- WBC, RBC and platelets are increased abnormally. An Increase in RBC can be suspective for polycythemia, but the increase in WBC can not be seen this much in that condition.

Liver is affected with increased bilirubin, an indicator of jaundice symptoms. However, kidney is not affected since creatinine falls in normal level.