Case Presentation: A healthy 65-year-old male was admitted to the hospital for presumed COPD exacerbation and despite treatment developed hypoxic respiratory failure and shock, transferring to the intensive care unit (ICU) for further management.On arrival, he was tachycardic (120 BPM), BP 74/47 mmHg, febrile (39.0℃) and mechanically ventilated (RR 14) concerning for septic shock. Examination [...]