M31.1/D59.3
DESCRIPTION
An acute syndrome that presents with diarrhoea/dysentery or renal infection with varying combinations of the following:
Non-immune microangiopathic haemolytic anaemia with fragmentation haemolysis (schistocytes), thrombocytopaenia often with purpura, acute renal insufficiency, fever and neurologic abnormalities.
DIAGNOSTIC CRITERIA
Investigations
- HIV testing
- INR/PTT is normal as compared to DIC where it is abnormal.
- Stool for Shiga toxin producing E coli.
- Blood cultures.
- FBC and smear.
- Urea and electrolytes.
MEDICINE TREATMENT
- Fresh frozen plasma (FFP) IV infusion, 30 mL/kg/day in 3-4 doses
OR - Freeze dried plasma (FDP), IV infusion, 30 mL/kg/day in 3-4 doses
For Infections
- Ceftriaxone, IV, 50–80 mg/kg once daily.
OR
If < 1 month old: - Cefotaxime, IV, 25–50 mg/kg/dose, 6 hourly.
Need for platelet transfusion to be discuss with a haematologist.
Early dialysis - discuss with a nephrologist.
REFERRAL
All patients - early consultation and transfer to a regional centre.