Stange symptoms

  1. On my ward there is a patient and the multi diciplinerary team has no idea what is wrong with her.

    Female Age 11

    Symptoms:low oxygen saturation,Temperature 39,Painful joints,Capilary refill time more than 4 seconds,Heart rate 112 per min,Hyper tension,Cold extremities

    Has not been out of the country in the past 6 months

    Lab results:

    Every thing is normal except these three
    Iron-Elevated
    Low red blood cell count
    Increased white blood count

    Thanks if you have ever come across this
    Last edit by Hopefulheart on Oct 9, '06
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    About Hopefulheart

    Joined: Oct '06; Posts: 2

    7 Comments

  3. by   sirI
    Hello, Hopefulheart and welcome to allnurses.com

    I suppose that renal/endocrine disorders have been ruled out? Normally, a high percentage of hypertension in that age is secondary to renal disorders.

    You didn't give any lab values, so not sure on the chemistries. What is the potassium value?

    Has the child ingested licorice, chewing tobacco, or herbs?

    Just throwing out some ideas here.....
  4. by   EricJRN
    No skin lesions? (Purpura, hives, etc?)
  5. by   Tweety
    Quote from siri
    You didn't give any lab values, so not sure on the chemistries. What is the potassium value?
    .....

    OP states all labs were normal...except those indicated.

    I'm quite intrigued. Painful joints would coincide with high iron counts of hemochromatosis. But it doesn't quite fit.
  6. by   sirI
    Quote from Tweety
    OP states all labs were normal...except those indicated.

    I'm quite intrigued. Painful joints would coincide with high iron counts of hemochromatosis. But it doesn't quite fit.
    OP came back and edited the original post with the lab info about 30 mins. after I responded.
  7. by   perfectbluebuildings
    It sounds kind of like JRA? And possibly Raynaud's. I have a friend with both of these illnesses that has these s/s. The low o2 sat could be r/t poor circulation to extremities, if they are cold. Hope you all can find soemthing to help this pt!
    Last edit by perfectbluebuildings on Oct 10, '06
  8. by   Hopefulheart
    Thanks for all your help!

    Tjhe answer came from one of the most unlikely and unfortunate places places- her little sister got real unwell and it was only then we thought to do a lumbar puncture.My patient ended up getting tranferes to a hospital with a bigger PICU but the sister is at our PICU.It turned out it was slow onset bacterial menigitis.I cant believe we missed that but the symptoms where confussing.It could have been fatal .I feel so guilty for missing it.
  9. by   sirI
    Thank you for the update. Agree the s/s were atypical for meningitis with s/s decompensation and rather unique to MANY disease processess.

    Glad they are doing o.k. now.

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