31 January 2022
: Case report 
Case Report: Rocky Mountain Spotted Fever with Adrenalectomy and a Hard-to-Find Tick
Rare disease
Chenxuan Zhou1BCDEF*, Pace Woods1ABCD, Andrew Abouzeid2BCD, Michelle N. Brooks2EGDOI: 10.12659/AJCR.934505
Am J Case Rep 2022; 23:e934505
Table 2. Complete laboratory testing performed before, upon, and after admission.
| Laboratory finding | Before admission* | On admission | 2 weeks after discharge** |
|---|---|---|---|
| Sodium | 135 mmol/L | 123 mmol/L | 140 mmol/L |
| Potassium | 4.4 mmol/L | 4.0 mmol/L | 3.6 mmol/L |
| Chloride | 106 mmol/L | 94 mmol/L | 109 mmol/L |
| Carbon dioxide | 24 mmol/L | 16 mmol/L | 27 mmol/L |
| Anion gap | 5 mmol/L | 13 mmol/L | 4 mmol/L |
| Osmolality | N/A | 278 mOsm/kg | N/A |
| Glucose | 85 mg/dL | 91 mmol/L | 77 mg/dL |
| BUN | 14 mg/dL | 35 mmol/L | 15 mg/dL |
| Creatinine | 0.89 mg/dL | 2.28 mmol/L | 0.81 mg/dL |
| GFR | 80 mL/min/1.73 m | 26 mL/min/1.73 m | 89 mL/min/1.73 m |
| AST | 23 unit(s)/L | 62 unit(s)/L | 21 unit(s)/L |
| ALT | 8 unit(s)/L | 7 unit(s)/L | 12 unit(s)/L |
| Alk phos | 93 unit(s)/L | 90 unit(s)/L | 112 unit(s)/L |
| Bilirubin, total | 0.2 mg/dL | 0.4 mg/dL | 0.3 mg/dL |
| Bilirubin, conjugated | 0.1 mg/dL | 0.3 mg/dL | 0.2 mg/dL |
| Protein, total | 6.4 g/dL | 5.1 g/dL | 5.9 g/dL |
| Albumin | 3.6 g/dL | 2.7 g/dL | 3.1 g/dL |
| Globulin | 2.8 g/dL | 2.4 g/dL | 2.8 g/dL |
| Calcium | 8.6 mg/dL | 8.7 mg/dL | 9.1 mg/dL |
| Magnesium | N/A | N/A | 1.5 mg/dL |
| Creatinine, urine | N/A | 21.6 mg/dL | N/A |
| Osmolality, urine | N/A | 125 mOsm/kg | N/A |
| Potassium urine | N/A | 9.4 mmol/L | N/A |
| Sodium, urine | N/A | <20 mmol/L | N/A |
| WBC | 7.3×10/L | 9.9×10/L | 7.7×10/L |
| RBC | 4.47×10/L | 4.05×10/L | 3.80×10/L |
| Hemoglobin | 13.2 g/dL | 11.8 g/dL | 10.9 g/dL |
| HCT | 40.8% | 35.0% | 33.6% |
| MCV | 91.3 fL | 86.4 fL | 88.4 fL |
| MCH | 29.5 pg | 29.1 pg | 28.7 pg |
| MCHC | 32.4 g/dL | 33.7 g/dL | 32.4 g/dL |
| RDW | 13.4% | 13.5% | 14.6% |
| PLT | 206×10/L | 153×10/L | 163×10/L |
| MOV | 12.4 fL | 12.7 fL | 12.5 fL |
| %Neu | 49.8% | 51.9% | 50.2% |
| %Lym | 42.3% | 36.2% | 40.7% |
| %Mono | 5.3% | 11.5% | 6.5% |
| %Eos | 1.8% | 0.1% | 2.1% |
| %Baso | 0.8% | 0.3% | 0.5% |
| NEU | 3.6×10/L | 4.1×10/L | 3.8×10/L |
| LYM | 3.1×10/L | 2.7×10/L | 3.1×10/L |
| MONO | 0.4×10/L | 1.1×10/L | 0.5×10/L |
| EOS | 0.1×10/L | 0.0×10/L | 0.2×10/L |
| BASO | 0.1×10/L | 0.0×10/L | 0.0×10/L |
| * This laboratory result was obtained 9 days prior to the admission and used as a baseline; ** this laboratory result was obtained 21 days after the admission during an oncology follow-up. | |||