Background: In the treatment of sepsis, current guidelines from the Surviving Sepsis Campaign recommend IV crystalloid 30ml/kg in the first three hours of admission (1). The 30mL/kg guideline is designated as a strong recommendation with low quality of evidence(2). This evidence largely stems from the Rivers et al. study of 263 patients which showed improved [...]

Background: BACKGROUNDSepsis has been recognized as a major cause of mortality and morbidity in the United States. If not recognized and managed promptly, it can lead to septic shock which is one of the leading causes of deaths in the hospital (WHO, 2020). To promote early identification and treatment of severe sepsis and septic shock, [...]

Background: Early identification of sepsis is the main driver for patient survival. Roughly 30% of patients diagnosed with severe sepsis do not survive. To drive the desired clinical behavior, it is crucial to identify appropriate sensitivity and specificity of a sepsis early detection system. At our institution, we saw a 515% increase in Sepsis Alerts [...]

Case Presentation: A 61 year old female presented to the emergency department with 1 day of nausea, vomiting, and fever. The day prior to her symptom onset, she had undergone a colonoscopy for colon cancer screening that was normal. Her medical history was notable for splenectomy in 2000 for a hamartoma.On presentation, her temperature was [...]

Case Presentation: Patient is a 51-year-old man who presented with complaints of progressively worsening dyspnea, productive cough, sore throat and intermittent fevers of about 1 week. He has a past medical history of tobacco use. Initial vitals showed a temperature – 100.5F, heart rate – 118 bpm ,blood pressure – 119mmhg/60mmhg , respiratory rate – [...]

Case Presentation: A 48-year-old man presents with chief complaints of fever, nausea, vomiting, rash and discoloration of hands and feet for 1 day. He was admitted to intensive care unit for septic shock and altered mental status. Patient was intubated and started on intravenous fluids, pressor medications and broad-spectrum antibiotics (vancomycin and piperacillin/tazobactam). On day [...]

Case Presentation: A 75-year-old gentleman with a medical history significant for tonsillar squamous cell carcinoma status post resection and a previous smoker who was undergoing surveillance CT chest/neck, showed a new 1.5 cm left hilar lymph node (LHLN) (Image 1) and recurrent cytologically negative right pleural effusion. He denied any interval respiratory symptoms. PET Scan [...]

Case Presentation: A 25-year-old African American female with a history of SLE and seizure disorder presented with generalized weakness, fever, odynophagia and loss of appetite for one day. At presentation her vital signs were T 101.5 °F, HR 126/min, BP of 90/56 and O2Sat 99% on room air. Initial laboratory results revealed WBC of 7.7 [...]

Case Presentation: A 20-year-old female with no past medical history presented to a rural hospital with shortness of breath, sepsis, and a several-day history of right-sided throat pain 2 weeks after a dental procedure. Chest x-ray demonstrated bilateral lung opacifications and blood cultures were positive for Streptococcus constellatus. She was started on broad-spectrum antibiotics and [...]

Case Presentation: An 80-year-old man presented with progressive worsening of altered mental status after a fall and right knee trauma. Four days prior he developed subjective fevers, chills and inability to walk after the fall. Past medical history was significant for diverticulitis complicated by diverticular abscess six months prior to admission. He was homebound, no [...]