1 Surgical Infection with disseminated intravascular coagulation reflection Misdiagnosis.docVIP

 PAGE \* MERGEFORMAT 5 1 Surgical Infection with disseminated intravascular coagulation reflection Misdiagnosis 1 clinical data Patients, male, aged 62, had July 10, 2007 due to “fever, sore right leg with erythema 1 week” in a central hospitals, hospitalized, diagnosed as “erysipelas”, to the “penicillin” infusion “ 50% magnesium sulfate, “moist heat, bed rest, the peak temperature for 1 week decreased, but the right leg was sore, and ascites, on July 18, 2007 go to the people of the state of a tertiary hospital, diagnosed as” erysipelas, hypoalbuminemia “, to third generation cephalosporin antibiotics, nutritional support, supplementary albumin, comprehensive treatment of bed rest, poor diet during hospitalization and rarely get out of bed, on August 14, 2007 in patients with right thigh had scattered pinpoint blood spots, review blood: PLT 154 10 9 / L, did not pay attention to the patients in the August 15, 2007 improved and discharged the morning after discharge, increased blood spots right thigh, August 15, 2007 main reason for the evening, “fever, asymmetric lower extremity swelling, ascites, 1 more than a month, with skin petechia 2 days” to our hospital (secondary hospital admission examination: T 38.0 C, P 90 beats / min, BP 130 / 80mmHg, passive posture, back admitted. spirit of the poor, poor nutrition, coarse breath sounds in both lungs, no smell, and wet and dry rales, asymmetric lower extremity swelling, right thigh with scattered petechiae in the tip size. emergency blood: WBC 19.9 10 9 / L, N 0.92, L 0.04, PLT 94 10 9 / L. clotting mechanism: the plasma prothrombin time (PT16.3 seconds (control 13.1 seconds, PT ratio (PTR0.652 (normal 0.58 -1.15, thrombin time (TT18.3 seconds, activated partial thromboplastin time (APTT49.6 seconds, fibrinogen 2.06 / L. admission diagnosis: surgical infection complicated with disseminated intravascular coagulation (DIC, low blood protein disease. admission to the 50mg intravenous heparin saline 100ml