Purpura on the truncus and extremities

Abstract

A 36-year-old woman with Down's syndrome and spleen hypoplasia presented with a fever of 40°C lasting for 12 h. She had taken 1 mg prednisolone/day for mild graft-versus-host disease after allogeneic stem cell transplantation 4 years previously. Her BP was 91/44 mm Hg, HR 110 beats/min and RR 30 breaths/min. Her heart sound, lung sound and skin appearance were unremarkable. Laboratory findings showed leucocytosis (13.12×109/L) and normal platelet count (269×109/L). She was discharged home, but 16 h after fever onset, experienced cardiopulmonary arrest. What does …