History of present illness Physical Exam Laboratory EXam ■T:40.1°C ■ Toxicology P:130 bpm ■ HCT and wbc: normal BP: 103/71mmHg ■N%↑,PLT↓ RR: 26 breaths/min Nat. K+ cl normal Withdrawn BG normal ■ confused ■Lac↑cO21 ■GCs:14 ■Rena| and liver function↑ ■OB
6 History of present illness Physical Exam T: 40.1 °C P: 130 bpm BP: 103/71mmHg RR: 26 breaths/min Withdrawn confused GCS: 14 Laboratory Exam Toxicology: - HCT and WBC: normal N% ↑, PLT ↓ Na+,K+,Cl- :normal BG:normal Lac↑ CO2↑ Renal and liver function ↑ OB: +
History of present illness CT scan DlagnosisMeasures Brain Vancomycin Abdomen Ceftriaxone Pelvis Acyclovir no acute Diazepam abnormality Normal saline Acetaminophen Meningitis Indwelling urinary catheter Blood culture Urine culture Transporation
7 History of present illness Vancomycin Ceftriaxone Acyclovir Diazepam Normal saline Acetaminophen Indwelling urinary catheter Blood culture Urine culture Measures Meningitis Diagnosis Brain Abdomen Pelvis no acute abnormality CT scan
additional histor Feeling awful Two dogs Diffuse muscle pain Traveling in Ireland 1 month ealier Neck stiffness Hunting in brush in Pain with swallowing Nevada 10 days before TE LOVE No headache or Arriving in New rash England on the day LOVETEXTLEVE before the onset of Gout symptoms Drinking but no No dental work and no tick or mosquito bites smoKing
8 Additional History Feeling awful Diffuse muscle pain Neck stiffness Pain with swallowing Gout Drinking but no smoking Two dogs Hunting in brush in Nevada 10 days before Traveling in Ireland 1 month ealier Arriving in New England on the day before the onset of symptoms No dental work and no tick or mosquito bites No headache or rash