Question

a female patient in the icu with sepsis due to pneumonia begins to have bleeding from all iv and central line sites and easily bruising of the skin. the morning labs reveal that the platelets are severely low, pt, ptt, d - dimer and inr are elevated significantly. a blood smear shows hemolysis of rbcs. the patient had normal labs just yesterday, what is the diagnosis?

• dic or disseminated intravascular coagulation due to sepsis
• essential thrombocytosis
• hus or hemolytic uremic syndrome because of e. coli o:h57 infection
• ttp or thrombotic thrombocytopenic purpura due to adamst13 deficiency

Explanation:

The patient has sepsis (a common trigger for DIC), with low platelets, elevated PT/PTT/d - dimer/INR (coagulation abnormalities), and hemolysis (RBC breakdown). Essential thrombocytosis has high platelets, HUS is linked to E. coli and has renal involvement (not mentioned here), TTP is due to ADAMTS13 deficiency and has specific clinical features (not matching here). DIC in sepsis causes widespread coagulation activation leading to these lab and clinical findings.

Answer:

A. DIC or disseminated intravascular coagulation due to sepsis