Case 147

 A five year-old girl came to our hospital with her mother. Her chief complaint was tarry stool. Four days before, she got nasal fluid and cough. Since the morning three days before, she frequently experienced vomits and could not eat much of food. From this morning, she suffered from abdominal pain and vomits. Oral findings revealed swollen and reddish oral pharynx indicating tonsillitis and pharyngitis. Auscultation indicated the increasing bowel sounds. Laboratory test revealed; white blood cells 13610/mm³, neutrophils 79.1%, lymphocytes 11.9%, platelets 350000/mm³, CRP 1.10 mg/dL, D dimer 12.70μg/mL: stool test, positive β hemolytic streptococcus A. She underwent abdomen CT for further examination (Figs. 1-3).

What is your diagnosis ?

1. 　Intussusception

2. 　Ulcerative colitis

3. 　O-157 colitis

4. 　IgA vasculitis

answer

2019.6.5