tokens: 188543380 NVH 24217709 06/07/2000 12:00:00 AM CHRONIC MYELOGENOUS LEUKEMIA Signed DIS Admission Date : 06/07/2000 Report Status : Signed Discharge Date : 07/02/2000 PRINCIPAL DIAGNOSIS : CML . OTHER DIAGNOSES : 1. STATUS POST BONE MARROW TRANSPLANT . 2. INTRAPARENCHYMAL BLEED . HISTORY OF PRESENT ILLNESS : Mr. Larsen was a 50-year-old salesman who in 12/26 was noted to have an elevated platelet count of 778,000 . He was found to have CML . He was admitted on 06/07/00 for a matched , unrelated donor bone marrow transplant . PHYSICAL EXAMINATION : Unremarkable . LABORATORY DATA : White blood cell count of 24.409 and platelets of 956,000 . HOSPITAL COURSE : The patient received his bone marrow transplant on 06/12/00 . His course was then complicated by fevers and neutropenia which were treated with antibiotics and a diffuse erythroderm felt to be a drug reaction . On 06/24/00 the patient was found to have pulmonary infiltrates and some hemoptysis . A bronchoscopy was done and there was blood found in the upper airways but no evidence of blood in alveoli so it was not felt to be DAH . On 06/26/00 due to agitation , change in mental status and increased respiratory distress , the patient was intubated . It was felt at that time that the changing mental status and respiratory distress might be due to a combination of medication and worsening mucositis . Although the patient &apos;s pain and sedation meds were adjusted he continued to be agitated and there was difficulty weaning him off the vent . Because of this continued agitation , a head CT was performed on 07/01/00 and it revealed an intraparenchymal hemorrhage . Neurosurgery was consulted but due to the severity of the bleed surgery was not considered an option . The patient gradually lost brain systolic ejection murmur function and was pronounced dead on 07/02/00 . Dictated By : LAYMIE LARSEN , M.D. EM08 Attending : ANA V. A , M.D. ZM0 LB414/6537 Batch : 67043 Index No. EZCDQ560N8 D : 07/19/00 T : 07/20/00