Internal Medicine

P1: RLJ/OZN P2: KUF

0521779407-D-01 CUNY1086/Karliner 0 521 77940 7 June 13, 2007 7:41

490 Disorders of Neutrophil Function Disseminated Intravascular Coagulation

■Also evaluate for other immunodeficiency syndromes and neu-

trophil functional defects

management

■Aggressive prophylaxis with prophylactic trimethoprim-sulfame-

thoxazole or dicloxacillin

■Prompt treatment of infection with parenteral antibiotics

■Surgical interventions including drainage of abscesses and resection

of infected tissue

specific therapy

■Prophylaxis with interferon-gamma helps decreases infections in

some patients

■Stem cell transplantation

follow-up

n/a

complications and prognosis

■Life-threatening infections shortens life expectancy

DISSEMINATED INTRAVASCULAR COAGULATION,

THROMBOTIC THROMBOCYTOPENIC PURPURA,

HEMOLYTIC UREMIC SYNDROME (DIC/TTP/HUS)

PETER W. MARKS, MD, PhD

history & physical

Associated with the Development of Disseminated Intravascular

Coagulation

■Infections: Gram-negative bacteria, encapsulated gram-positive

bacteria, viruses (varicella, Rocky Mountain spotted fever)

■Malignancies: Myeloid leukemia, lymphoma, solid tumors (esp. ade-

nocarcinoma)

■Obstetric complications: Placental abruption, amniotic fluid embo-

lus, retained products of conception, eclampsia

■Miscellaneous: Trauma, burns, snakebites, hemangiomas

Associated with the Development of TTP/HUS

■Infections: E. coli 0157:H7, Shigella (verotoxin-producing), HIV

■Drugs: clopidogrel, ticlopidine, quinine, cyclosporin, tacrolimus,

gemcitabine, mitomycin C