‘Coronitis Pigmentosa’ – A blind diagnosis?

Author: Dale Kirkwood / Editor: Yasmin Sultan  / Codes: Published: 19/03/2021

A 39-year-old female is taken into resus as red flag sepsis. She is scoring an EWS 3.

Her observations are:
Temperature 38.7
HR 103
SBP 109/78
RR 20
Sats 96% in air

Nurse triage suspects Covid.

The history revealed several days of sweating, fevers, head and muscle aches for which she was self-medicating. She called 111 due to persistent, otherwise unremarkable, vomiting for the last 24 hours.

Past medical history: Bipolar Disorder
Medication: Amlodipine, Simvastatin and Lamotrigene.
Social History: Smokes 10 a day and reported occasional alcohol intake

OE She was actively vomiting. Her mentation appeared slow. She had mild epigastric tenderness and a hint of jaundice in the sclerae.

Venous Blood Gas
pH 7.29
Pa02 11
PaCO2 4.3
HCO3 12
BE -14
Na+ 135
K+ 5.1
Cl- 96
Lactate 17
Glucose 3.8

The VBG was repeated immediately and returned the same result. Other blood tests are still pending.

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