Fulminant thrombotic microangiopathy in Pediatrics: Where diagnostic and therapeutic dilemmas meet

摘要

We received a request to admit a previously healthy 17-month-old male infant to our tertiary critical care unit for decompensated respiratory distress, associated with fever, acute jaundice, and severe electrolyte imbalances of unknown origin. The patient had recently been treated by his primary pediatrician for acute otitis media with a 3-day course of amoxicillin. At his arrival in the outside facility's emergency department, his clinical exam revealed respiratory distress, hyperthermia, poor peripheral perfusion as well as acutely progressive Icterus. Pulse oximetry was >95% on a non-rebreather oxygen mask, but decreased breath sounds were noted on the left. A chest X-ray showed diffuse left-sided opacification without effusion or pneumothorax. Laboratory tests indicated acute renal failure, severe hyperkalemia, thrombocyto-penia, and anemia.