Background: Clinical decision support tools based on predictive analytics can provide actionable information and improve clinical outcomes for patients at risk of developing sepsis. Scoring systems such as Systemic Inflammatory Response Syndrome (SIRS) and National Early Warning Score (NEWS) that were not specifically trained to detect sepsis tend to have high false alarm rates, leading [...]

Background: Clinical decision support tools based on predictive analytics can provide actionable information and improve clinical outcomes for patients at risk of developing sepsis. Scoring systems such as Systemic Inflammatory Response Syndrome (SIRS) and National Early Warning Score (NEWS) that were not specifically trained to detect sepsis tend to have high false alarm rates, leading [...]

Background: Sepsis, which is life-threatening organ dysfunction occurring in response to systemic infection, is a frequently fatal syndrome for which early recognition and treatment are paramount. While there are some reports that female and black patients with sepsis experience greater delays in time to antibiotics, there is an overall paucity of published data on whether [...]

Background: Procalcitonin (PCT) is a precursor peptide to calcitonin produced by the thyroid parafollicular cells, and the intestinal and lung neuroendocrine cells. PCT is a proinflammatoy marker specific to bacterial infections, and was initially used clinically to guide antibiotic therapy in lower respiratory tract infections. PCT has seen its role expanded to aid with initiation, [...]

Background: Sepsis research is limited by heterogeneity and inaccuracy of patient identification. An ideal identification algorithm would broadly define a population with suspected infection to optimize discrimination and provide real-time identification of high-risk populations for potential interventions. We combined clinical and administrative to identify a population of adults hospitalized with suspected infection and examined characteristics [...]

Background: The clinical evaluation of febrile neonates ≤ 60 days has been extensively debated in the age of doing less invasive testing to yield the same clinical outcomes with fewer complications. Rates of serious bacterial infections (SBI) in this population have been reported to be between 8.5% and 12%, and up to 20% in neonates [...]

Background: Blood stream infection is associated with high mortality and morbidity. Blood cultures are considered the gold standard for diagnosing bacteremia in sepsis patients. However, blood culture results may take at least 12 to 24 hours for a positive result and may even be complicated by contamination. Procalcitonin (PCT) a biomarker for bacterial infection is [...]

Case Presentation: A 29-year-old Caucasian woman presented to the emergency department with fever, sore throat, epigastric and right upper quadrant abdominal pain of 5 days duration. Physical examination was positive for fever (40oC), tachycardia (heart rate 114 beats per minute), and a palpable liver and spleen on abdominal examination. Notable laboratory investigations included pancytopenia – [...]

Case Presentation: A 49 year-old man with a recent diagnosis of myasthenia gravis presented with 3 days of fever up to 103, rhinorrhea, frontal headache, mild lower extremity weakness, a mildly productive cough, and a leukocytosis to 16. As he had been started on prednisone and azathioprine 10 days prior to his presentation, he underwent [...]

Case Presentation: A 53 yo female presented with a subacute syndrome of intermittent fevers, fatigue, heliotrope rash, weight loss, fingertip necrosis, and nodular skin lesions. Skin biopsy was positive for septal and lobular granulomatous panniculitis. Serology was positive for antinuclear antibody (ANA) and anti-ribonucleoprotein (RNP), negative for other vasculitis and rheumatologic autoantibodies. She was diagnosed [...]