Published 4 February 2009, doi:10.1136/bmj.b200
Cite this as: BMJ 2009;338:b200

Endgames

Case report

A chicken sandwich leading to intensive care

R Som, foundation year 2 doctor, R Wynne-Simmons, foundation year 2 doctor, J Islam, specialty trainee in medicine, S Lawman, consultant nephrologist

1 Sussex Kidney Unit, Royal Sussex County Hospital, Brighton BN2 5BE

Correspondence to: R Som rsom@doctors.org.uk

The first 150 words of the full text of this article appear below.

A 28 year old man presented to the accident and emergency department with central abdominal pain that had lasted just over a day and was "cramping" in nature. He had had bloody diarrhoea for three days, with increasing frequency and amount of blood. He had eaten a chicken sandwich purchased from a canteen the day before the onset of symptoms. There was no history of recent foreign travel or any important medical history.

On examination he was found to be warm and well perfused, and his abdomen was soft, with mild generalised tenderness. On admission his full blood count, renal function and liver function tests were all within normal range.

Three days after admission he had persistent bloody diarrhoea; his haemoglobin concentration had dropped by 40 g/l to 126 g/l. Colonoscopy and biopsies showed acute indeterminate colitis. His white cell count was 23.3x109/l, neutrophils 19.1x106. . . [Full text of this article]

Investigations in haemolytic uraemic syndrome

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