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 x 109/L, a hemoglobin of 9.0 gm/dl, WBC count of 22x 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 patient's presentation with fever, thrombocytopenia, hemolytic anemia with schistocytes and elevated WBC count points towards a diagnosis of thrombotic thrombocytopenic purpura (TTP). The use of penicillin could have triggered an immune response causing antibodies to form against ADAMTS13 enzyme, leading to the development of TTP. D-HUS, DIC and HELLP syndrome may also present with similar features, but the absence of renal dysfunction and liver enzyme abnormalities rules out D-HUS and HELLP syndrome respectively, while the presence of polychromasia makes DIC unlikely.

A 20 Year Old Disoriented Female Is Brought to the Hospital