You are working night shifts on A&E/MAU in a rural DGH. A 29-year-old man presents via A&E with a three-week history of cough and fatigue. On examination you note significant pallor and a petechial rash. His tonsils are enlarged and inflamed and he has poor dentition. Baseline obs show that he has a fever of 39 c and is slightly tachycardic (HR118, BP 100/40, sats 93%, RR 18). A full blood count is phoned through to the department and shows:
- Hb 69 g/l
- Plts 33
- WCC 14
Please answer the following question:
What is the possible differential diagnosis?
Please reply on Twitter and always include #teamhaem to allow others to follow your comments. This case is designed particularly with non-haematologists in mind so please join in the debate and learn about haematological/oncological emergencies along the way. The case will continue to evolve over the coming week so keep checking #teamhaem for more information.
Please note – all cases on Teamhaem are entirely fictional to protect patient confidentiality.