Take our new Case Challenge!

Posted by Jennifer Zeis • January 30th, 2014

In our latest Case Challenge, a 59-year-old-man was admitted because of fever, confusion, rash, thrombocytopenia, and renal failure.  He had been well until 3 days before admission, when flu-like symptoms developed while he was traveling.  The patient’s hematocrit and white-cell count were normal, the platelet count was decreased, and the percentage of band forms was elevated.  A chest radiograph was normal, but results of tests of renal and liver function were elevated, and testing for occult blood in the stool was positive.  What is the most likely diagnosis?

Read the rest of the case and submit your diagnosis via our online poll.  On Wednesday, February 12, results will be posted with the latest Case Record of the Massachusetts General Hospital on NEJM.org.

159 Responses to “Take our new Case Challenge!”

  1. Jana says:

    DIC (due to viral infection perheps?) or a vaskulitis as a result of an autoimun cross reaction to an infect.

  2. sawan jagnarian says:

    the answer is ITP

  3. MOHAMMAD says:


  4. edgar says:

    sindrome uremico-hemolitico

  5. Dr Shamil PK says:


  6. Satyadharma Michael says:

    Thrombotic Thrombocytopenic Purpura


    levidoreticularis on the abdomen skin.the overall picture suggest APL VS TTP/HUS

  8. Duret Pierre says:

    Thrombotic micro-angiopathy like thrombotic thrombocytopenic purpura.

  9. dr.rajkumar says:

    Viral hemorrhagic fever.

  10. Paul Pritchard says:

    Dengue Fever

  11. Alfonso Martinez perez says:

    El diagnostico es una encefalopatia hepatica secundario a una colangitis

  12. dr. aisha arif says:

    Most probable diagnosis is thrombotic thrombocytopenic purpura TTP.

  13. satyasrinivas says:

    poosibility hanta virus infection

  14. naw says:

    Kala azar?

  15. Ala' Hawa says:

    HUS :)

  16. Hoang says:

    Septic shock

  17. germanosorio says:

    Virus del dengue- Dengue hemorragico