Case stud y
1 Case Study
CASE RECORDS ofthe MASSACHUSETTS GENERAL HOSPITAL Founded by Richard. Cabot Eric S. Rosenberg, M.D., Editor Nancy Lee Harris, M.D., Editor Jo-Anne O. Shepard, M.D., Associate Editor Alice M. Cort, M.D., Associate Editor Sally H. Ebeling, Assistant Editor Emily K. McDonald, Assistant Editor Case 5-2014: 59-Year-Old Man with Fever, Confusion, Thrombocytopenia, Rash, and Renal Failure Meridale V. Baggett, M.D., Sarah E. Turbett, M.D., Shmuel S. Schwartzenberg, M.D., and James R. Stone, M.D., Ph.D. LOVE
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Chiet Complaint Male, 59 yrs Admitted because of fever confusion, thrombocytopenia, rash and renal failure R
3 Chief Complaint Male, 59 yrs Admitted because of fever, confusion,thrombocytopenia, rash, and renal failure
History of present illness Vomiting, diaphoresis and 3 increasing fatigue while traveling Feverish - Ibuprofen Nonverbal. unable to stand but able to respond to painful stimul
4 Vomiting, diaphoresis and increasing fatigue while traveling History of present illness 3 2 1 Feverish Nonverbal, unable to stand, but able to respond to painful stimuli Ibuprofen
History of present illness BP132/80mmHg P 110 bpm rr 26 breaths per min Naloxone and SpO294%(2L/min transferred Pupils 3mm and nonreactive BG8.2mmol/L E ECG sinus tachycarida(132 bpm)
5 History of present illness BP 132/80mmHg P 110 bpm RR 26 breaths per min SpO2 94% (2L/min) Pupils 3mm and nonreactive BG 8.2mmol/L ECG sinus tachycarida (132 bpm) Naloxone and transferred