A 20-year-old disoriented female is brought to the hospital with a fever of 102°F.Results of the CBC demonstrate a platelet count of 68 × 10⁹/L,a hemoglobin of 9.0 gm/dl,WBC count of 22 × 10⁹/L,and the presence of polychromasia and schistocytes on the peripheral blood smear.Her husband indicated she had no recent episodes of diarrhea but had been taking penicillin for an ongoing infection.The most likely diagnosis for the patient is:

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The combination of fever, thrombocytopenia (platelet count of 68 × 10⁹/L), microangiopathic hemolytic anemia (shown by the presence of schistocytes and polychromasia), and high leukocyte count (22 × 10⁹/L) suggests the diagnosis of thrombotic thrombocytopenic purpura (TTP). The patient's history of penicillin use may have triggered the development of TTP. The other options (D-HUS, DIC, HELLP syndrome) may also present with some overlapping features, but none of them completely fit the clinical picture described.

A 20-Year-Old Disoriented Female Is Brought to the Hospital with a Fever