sepsis – Jacobi IM Residency

jacobi August 3, 2017August 3, 2017ImageTidbits, Weekend CoverageID, sepsis, toxoplasmosis, weekly image

weekly image 0803

39M from DR, h/o AIDS (CD4 = 40, VL 250k) not on HAART, p/w AMS, also have decreased ambulation/appetite/speaking/ambulation for 2 wks Vitals: 98.3/55/18 BP: 100/60 What is the differential diagnosis ? What to do for this patient ? From NEJM Teaching Topics | February 23, 2012 Q. What neoplastic processes are part of the differential diagnosis of a peripherally enhancing brain lesion? The differential diagnosis of a peripherally … Continue reading “weekly image 0803”

jacobi July 20, 2017AsideTidbitsEducation, Pulm/CCM, sepsis, shock

Pressors

Highlights from Sepsis surviving Campaign 2016: Base on ProCESS, ProMISe and ARISE trials, all 3 trials confirmed that there was no survival benefit of EGDT compared to usual resuscitation. However, in all three studies patients had early antibiotics, >30ml/kg of IVF prior to randomization. We need therefore to keep in mind that the practice has changed. Source control: empiric broad-spectrum therapy Abx to cover all likely pathogens within 1hr Initial resuscitation: 30ml/kg of IV crystalloid fluid in first 3 hours … Continue reading “Pressors”