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Question 8

A 54 year old man presents with shortness of breath and cough productive of green sputum.  He is diagnosed by the general medical team with pneumonia and Pneumococcus is subsequently grown from blood cultures taken on admission.  On admission his PT is noticed to be deranged and he is not on any anticoagulants.  He is treated with antibiotics and his chest infection improves.  However, his PT remains abnormal and you are asked to advise prior to discharge.  

You review the patient on the ward and discover he has a history of excessive bleeding following a dental extraction but has not had any other significant haemostatic challenges. 

Hb 14.3 WC 9.4 Plts 423

PT 32.5 APTT 29.6 Fibrinogen 2.7

What further investigations would you request?

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