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 40-year-old woman with a history of anxiety presented with one week of diffuse abdominal pain, associated with constipation, decreased oral intake, nausea, and bilious emesis three times a day. She was admitted to an outside hospital one month prior with similar symptoms and treated for pneumonia. The patient lives alone and denied [...]

Case Presentation: A 29-year-old previously healthy male presented to an outside hospital emergency department with two days of flu-like symptoms including fever, chills, nausea, vomiting, abdominal pain, and recurrent episodes of syncope. On arrival, physical exam revealed a heart rate of 50 beats/minute and a blood pressure of 75/53 mmHg, elevated JVP, diminished right basilar [...]

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 67-year-old Fijean woman presented to the emergency department with three weeks of fevers, chills, weakness, watery non-bloody diarrhea, and unintentional 15lb weight loss. She had no recent travel, sick contacts, changes in dietary habits, antibiotic use, or initiation of new medications. Physical exam was significant for epigastric tenderness and hepatomegaly. Her laboratory [...]

Case Presentation: A 77-year-old male with a PMH of atrial fibrillation, coronary artery disease, type 2 diabetes, hypertension and hyperlipidemia presented for a mechanical fall. He endorsed generalized malaise, subjective fevers, chills and fatigue days prior to the event. He denied any headache, cough or shortness of breath. On physical exam, he was febrile and [...]

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 [...]

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 [...]