Hematology Case 39
Hematology Case 39
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Presented By Dr Mohammad Moharram
Released on 21/6/2020Patient Data
Patient Data
49 year old male
Clinical Data
Clinical Data
Patient has long history of DM and hypertension.
Patient had brain tumor 20 years ago. The tumor was removed surgically and ventriculoperitoneal (VP) shunt was inserted.
2 days ago patient was admitted in our hospital because of severe headache and dizziness.
C.T. brain showed pneumoceohalus involving upper lateral ventricles, no intracranial hemorrhage, and no brain oedema.
Related Laboratory Results
Related Laboratory Results
- Fasting blood glucose: 8.6 mmol/L (R.R.: 3.9-5.6)
- CBC:
WBC: 18.3 X 103 /uL (Neutrophils: 16.1 X 103 /uL - Lymphocytes: 1.6 X 103 /uL)
HGB: 15 g/dL
Platelets: 189 X 103 /uL
- BUN: 9.8 mmol/L (R.R.: 2.5-6.4)
- Creatinine: 162 umol/L (R.R.: 55-113)
- AST: 44 u/L (R.R.: 15-40)
- ALT: 90 u/L (R.R.: 17-63)
- ALP: 186 u/L (R.R.: 32-91)
- CSF sample was send to hematology lab (see below) and microbiology lab.
Case Picture(s) / Photo(s)
Giemsa StainCase Picture(s) / Photo(s)
Comment / Findings
Comment / Findings
- CSF white cell count: 0.2 X 103 /uL
- Giemsa Stained Film Show:
Neutrophils: 81%
Lymphocytes: 19%
Many Diplococci are seen in the Giemsa stained film for microbiological correlation.
Final Diagnosis
Final Diagnosis
Secondary CNS bacterial infection (?? meningoencephalitis )
Additional Note
Additional Note
- Gram stain reveled moderate number of gram negative diplococci.
- CSF culture reveled acinetobacter baumani (MDR)
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