Question

A 29-year-old woman is brought to the emergency room by her roommate. The patient's illness began 48 hours earlier with vomiting and diarrhea. The patient reports no travel history. Otherwise, she is healthy, with the exception of vaginitis for 1 week before becoming ill. Examination reveals a fever of 38.9° C, hypotension, generalized erythematous rash with desquamation, conjunctivitis, and hyperemic vaginitis. Laboratory results indicate renal failure and thrombocytopenia. Liver enzymes are elevated, but she is not icteric. Blood cultures are negative. What is the most likely diagnosis? Answer Choices: A Neisseria meningitidis septicemia B Leptospirosis C Measles D Malaria E Toxic shock syndrome

Answer 1

The most likely diagnosis for the 29-year-old woman with symptoms like fever, vomiting, diarrhea, and rash, in addition with lab results indicating renal failure and thrombocytopenia, is Toxic Shock Syndrome (TSS). This condition often linked to Staphylococcus aureus or Streptococcus pyogenes infections, is a severe and potentially life-threatening disease that requires immediate treatment.

Step-by-step explanation:

The presentation of symptoms in the 29-year-old patient such as fever, vomiting, diarrhea, hypotension, conjunctivitis, and rash with desquamation are indicative of a condition known as Toxic Shock Syndrome (TSS). This condition is often associated with the use of tampons in menstruating women. The presence of vaginitis prior to this illness suggests a pre-existing Staphylococcus aureus or Streptococcus pyogenes infection which are commonly associated with TSS. The symptoms of TSS include nausea, vomiting, diarrhea, confusion, severe rash, redness of eyes, mouth, and throat, which describe the symptoms of the patient. Also, in severe cases of TSS, it could lead to renal impairment and thrombocytopenia which are reflected in the lab results of this patient. After ruling out other possible diseases with the given symptoms, among the answer choices given, such as Neisseria meningitidis septicemia, Leptospirosis, Measles, and Malaria, the most probable diagnosis is thus Toxic Shock Syndrome.

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