Difference between revisions of "IPLab:Lab 13:Meningococcemia"

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This 20-month-old black female was active and without complaint until 4 p.m. on the evening prior to her death, when according to her mother she acted as if she did not feel well. The mother reported that the child had felt warm at bedtime (8 p.m.) so she had given her some acetaminophen. At midnight, the child was given another dose of acetaminophen. The child slept with her mother that night who reported last hearing her daughter make a sound at approximately 7:30 a.m. The mother checked in on her daughter at 8:45 a.m. and found her to be unresponsive. The girl was dead when paramedics arrived. Her past medical history was unremarkable and there had been no recent illness among other family members.
 
This 20-month-old black female was active and without complaint until 4 p.m. on the evening prior to her death, when according to her mother she acted as if she did not feel well. The mother reported that the child had felt warm at bedtime (8 p.m.) so she had given her some acetaminophen. At midnight, the child was given another dose of acetaminophen. The child slept with her mother that night who reported last hearing her daughter make a sound at approximately 7:30 a.m. The mother checked in on her daughter at 8:45 a.m. and found her to be unresponsive. The girl was dead when paramedics arrived. Her past medical history was unremarkable and there had been no recent illness among other family members.
  
== Autopsy Findings ==
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At autopsy external examination revealed multiple purpuric and ecchymotic cutaneous lesions, most notable in the inguinal areas. Microscopic examination of these skin lesions revealed thrombosis and rupture of small dermal vessels. There were scattered visceral petechial hemorrhages and both adrenal glands were grossly hemorrhagic. There was no gross or microscopic evidence of meningitis. However, a Gram stain of cerebrospinal fluid showed Gram-negative diplococci. Cultures were positive for Neisseria meningitides.
External examination revealed multiple purpuric and ecchymotic cutaneous lesions, most notable in the inguinal areas. Microscopic examination of these skin lesions revealed thrombosis and rupture of small dermal vessels. There were scattered visceral petechial hemorrhages and both adrenal glands were grossly hemorrhagic. There was no gross or microscopic evidence of meningitis. However, a Gram stain of cerebrospinal fluid showed Gram-negative diplococci. Cultures were positive for Neisseria meningitides.  
 
  
 
== Images ==
 
== Images ==
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=== Images ===
 
=== Images ===
* [http://peir.path.uab.edu/library/index.php?/tags/2175-meningococcus PEIR Digital Library: Meningococcemia Images]
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* [{{SERVER}}/library/index.php?/tags/2175-meningococcus PEIR Digital Library: Meningococcemia Images]
* [http://peir.path.uab.edu/library/index.php?/tags/2176-adrenal_hemorrhage PEIR Digital Library: Adrenal Hemorrhage Images]
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* [{{SERVER}}/library/index.php?/tags/2176-adrenal_hemorrhage PEIR Digital Library: Adrenal Hemorrhage Images]
 
 
== Related IPLab Cases ==
 
 
 
  
 
{{IPLab 13}}
 
{{IPLab 13}}
  
 
[[Category: IPLab:Lab 13]]
 
[[Category: IPLab:Lab 13]]

Latest revision as of 21:37, 9 July 2020

Clinical Summary[edit]

This 20-month-old black female was active and without complaint until 4 p.m. on the evening prior to her death, when according to her mother she acted as if she did not feel well. The mother reported that the child had felt warm at bedtime (8 p.m.) so she had given her some acetaminophen. At midnight, the child was given another dose of acetaminophen. The child slept with her mother that night who reported last hearing her daughter make a sound at approximately 7:30 a.m. The mother checked in on her daughter at 8:45 a.m. and found her to be unresponsive. The girl was dead when paramedics arrived. Her past medical history was unremarkable and there had been no recent illness among other family members.

At autopsy external examination revealed multiple purpuric and ecchymotic cutaneous lesions, most notable in the inguinal areas. Microscopic examination of these skin lesions revealed thrombosis and rupture of small dermal vessels. There were scattered visceral petechial hemorrhages and both adrenal glands were grossly hemorrhagic. There was no gross or microscopic evidence of meningitis. However, a Gram stain of cerebrospinal fluid showed Gram-negative diplococci. Cultures were positive for Neisseria meningitides.

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Cyanosis is a bluish discoloration of the skin and mucous membranes resulting from increased concentrations of reduced hemoglobin in the blood. Cyanosis occurs when the blood oxygen saturation falls below 85%.