Case number 27

A 38-year-old man -newly diagnosed as high grade B cell lymphoma - who received bendamustin as the chemotherapy agent 4 days ago came to the emergency ward with the complaint of severe diarrhea (10 times a day) and significant urine output reduction.
On examination he was drowsy and severely agitated but oriented to time and place and person.
Vital signs:
BP 110/70
PR 120
T 39
SpO2 94% room air
RR 28

Multiple cervical, axillary, and inguinal lymph nodes and splenomegaly about 4cms below costal margin were palpable.

ECG showed sinus tachycardia.

Initial laboratory tests:
WBC 1500
Hb 7
Plt 30000
BUN 150
Cr 4.8 (baseline 0.8 a month ago)
Na 140
K 3.8
CRP 120
ESR 80