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Washington University Experience | MYELIN (NON-IMMUNE MEDIATED) | Fat Embolism | 8A0 Case 8 History - Copy
Case 8 History (AANP 2013 Case 4) ---- The patient is a 68-year-old woman who is a missionary with recent travel history to Ghana. She presented with neutropenia, odynophagia, and fever. Her mental status subsequently declined and progressed to a comatose state. Head imaging studies revealed multiple small white matter lesions with signal properties suggesting petechial hemorrhages, prompting radiological differential diagnoses of acute hemorrhagic leukoencephalopathy and vasculitis. She also carried a diagnosis of ocular toxoplasmosis that was being treated with Bactrim. Neutropenia during her hospital stay led to a bone marrow biopsy which showed infarcts. Further testing revealed that she had sickle cell trait.
