Case 37 part 3 – update 1

The patient is rather unwell with a community acquired pneumonia and requiring supplemental oxygen and intravenous antibiotics. She is not ‘septic’ with low BP etc. There is no history of bleeding and the coagulation screen 5 years pre knee operation was normal. Further testing has been done:

  • PT 14s (11-14s)
  • APTT 48s (33-40s)
  • APTT 50:50 mix 47s
  • Fibrinogen (Clauss) 4.9g/L (1.5-4.5g/L)
  • Thrombin time 16s (15-19s)


  • What explains the above findings?
  • What further testing do you need?
  • How do you follow this up?
  • Can she have prophylactic LMWH?

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