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 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 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 50-year-old male healthcare worker with a past history of splenectomy secondary to EBV complications, mild persistent asthma, and type 2 diabetes mellitus presented to the emergency department with acute hypoxic respiratory failure secondary to COVID-19 pneumonia. He quickly progressed to septic shock with worsening hypotension, tachycardia, lactic acidosis, increasing oxygen demands, and [...]

Case Presentation: A 53 year old man with uncontrolled diabetes type 2, hypertension, obese, stage III chronic kidney disease, chronic lower extremity edema with venous stasis, and recurrent lower extremity cellulitis was admitted to a large Quaternary medical center with 2 days of fever, chills, left lower extremity swelling, redness and pain. Started when he [...]

Case Presentation: A 77-year-old woman with a significant health history including metabolic syndrome, chronic obstructive pulmonary disease, ischemic cardiomyopathy, stage III chronic kidney disease and a recently diagnosed SARS-CoV-2 infection. She presented with sepsis and cardiorenal syndrome. On arrival, she was in acute respiratory distress with severe metabolic and respiratory acidosis, and in oliguric state, [...]

Case Presentation: A 47-year-old man with a history of metastatic colon cancer status post resection and rheumatoid arthritis presented to the emergency department with 4 days of fever, shortness of breath, fatigue and myalgias. He described fevers in a periodic pattern with spikes occurring about 3 times per day. He was found to be tachycardic [...]

Case Presentation: Sepsis is a primary cause of death in nearly 23.5% of chronic heart failure patients. The relationship between acute cholecystitis and cardiovascular disease is vague but there have been few studies suggesting cholecystocardiac link. Here we describe a similar case that presented as pulmonary edema and myocardial ischemia.81-year-old male with past medical history [...]