A father 76y.o. and son 34 y.o. come in to the clinic after a hiking trip they think that they may have encountered something on their hike that made them ill. The son has fever, chills, myalgias, malaise, nausea, andorexia, and some jaundice. The father has SOB, fever, chills, myalgias, malaise, nausea, anorexia, headache and jaundice as well as bruising and purpura. On peripheral smear they both have cirucular staining organisms that look similar to malaria. and the both have elevated liver enzymes, thrombocytopenia and hemolysis/anemia. What do they have (hint: it is the same disease) ? why is dad presenting differently? What is your biggest concern?
- Dad is over 50 which is a risk factor for severe disease
- You are not as worried about the son because the disease is usually self limited in young healthy individuals however the father is over 50 so he is at higher risk of severe disease including: severe hemolytic anemia, severe thrombocytopenia, end organ failure, ARDS, and renal failure, DIC, hypotension shock and death