Question
A 26 year old women with third degree burns developed septic shock. With 24hours she was bleeding from all needle puncture sites, with extensive ecchymoses and petechiae and GI Bleeding. Lab studies showed Hb- 6gm/dl., platelet count 64000/cu mm., PT 20 seconds, PTT 50 seconds and D-dimer Positive.
What is your most probable clinical diagnosis
Answer
Correct answer: c) Disseminated Intravascular coagulation
This clinical picture — septic shock (a classic DIC trigger, here following severe burns) with bleeding from multiple sites simultaneously (needle punctures, ecchymoses, petechiae, GI bleed), thrombocytopenia, prolonged PT and aPTT, and a positive D-dimer — is diagnostic of disseminated intravascular coagulation, reflecting simultaneous widespread microthrombosis and consumption of platelets/clotting factors with secondary hyperfibrinolysis.