Background: In 2016, the Sepsis-3 taskforce posited that acute organ failure is the defining feature of sepsis. Accordingly, they recommended that an acute rise in the Sequential Organ Failure Assessment (SOFA) score by 2 points over baseline should replace the Systemic Inflammatory Response Syndrome (SIRS) score as the sepsis criteria (1). As a justification, they […]

Case Presentation: A 21-year-old man with no previous medical history presented to the emergency department with nausea, vomiting and diarrhea for one week. Labs were significant for white blood cell (WBC) count 3.4 k/ul with decreased lymphocytes along with mild elevation of transaminases and lipase. He was thought to have viral gastroenteritis and was discharged. […]

Case Presentation: A 70-year-old male with a medical history significant for transurethral resection of bladder tumor and lung adenocarcinoma presented with diaphoresis and subjective fever 4 days after undergoing an uncomplicated aortic extension cuff placement for an abdominal aortic aneurysm. The patient was hemodynamically stable. Labs notable for leukocytosis of 18.4X10E9 cells/liter. CT abdomen demonstrated […]

Case Presentation: A 42-year-old female presented to the emergency department with a 2-week history of jaundice, intermittent abdominal pain, hip pain, and fevers. Her past medical history was significant for ankylosing spondylitis. She was on chronic immunosuppression with prednisone, Plaquenil and Infliximab. Initial evaluation was remarkable for abnormal liver function and thrombocytopenia (Table 1). The […]

Case Presentation: A 35-year-old male with past-medical-history significant for cerebral palsy and ventriculoperitoneal shunt for ventriculomegaly was admitted with fever. Patient had completed a course of levofloxacin before admission. Patient was started on azithromycin and meropenem, for possible aspiration pneumonia, because of penicillin allergy. He continued to be febrile with elevated leukocytes despite antibiotics. Considering […]