http://www.appliedradiology.com RSS Feed on Applied Radiologyhttp://www.appliedradiology.com//12-week-old-female-infant-with-fever-and-rash.aspx<p>This 12-week-old female infant born at term after an uncomplicated pregnancy presented to the emergency room with a fever, rash, acrocyanosis of the fingers and toes, and lethargy.  The white count was 34,000 (normal 6,000-17,500); hematocrit was 20.9 (normal 28-42) and hemoglobin was 6.2 g/dl (normal 9-14 g/dl). Thrombocytosis was present with measured at 916,000 /µL. Erythrocyte sedimentation rate (ESR) was 50 mm/hr (normal 0-20 mm/hr), and the C-reactive protein (CRP) was normal. Echocardiography, performed because of suspected congestive heart failure, demonstrated abnormal coronary arteries with aneurysms, measuring up to 5 mm in size. A computed tomography (CT) scan of the chest, abdomen, and pelvis was performed on a Somatom Definition AS 64 row scanner (Siemens, Forchheim Germany). Images were obtained following the administration of 13 mL of Optiray-350 nonionic contrast material (Covidien, St. Louis, MO) (Figure 1). The acquisition parameters were 0.6 mm collimation, 65 auto mAs, 80 auto kV, pitch of 1, and a gantry rotaion time of 0.33 sec. CT dose index (CTDI) volume was 1.07 mGy and dose length product (DLP) was 47 mGy·cm. Using the conversion factor (0.044 mSv/(mGy·cm) for trunk CT examinations, effective dose (E) is estimated to be 2.1 mSv (47 mGy·cm x 0.039). Over the next few days, progressive ischemia and gangrene of the fingers and toes occurred.<br /></p>Friday, 17 Jun 2011 10:35:38 GMT