Feeling Hot, Hot, Hot

Author: Jessie Lynch, John Ryan, Jeffrey Mulcaire / Editor: Steve Corry-Bass / Reviewer: Jessie Lynch / Codes: Published: 15/08/2023

A previously well 29-year-old male presents with a 3 day history of shortness of breath, pyrexia, abdominal pain, vomiting, diarrhoea, fatigue and general malaise. He sustained a laceration to his left elbow 1 week ago from a hockey pitch. He also had a large amount of alcohol and cocaine 4 days ago. 

On examination he is febrile (39.1C), tachycardic (120bpm) and tachypnoeic (RR27). He is drowsy and disoriented. He has a normal cardiorespiratory examination, and his abdomen is diffusely tender but soft. He has a laceration on his left elbow, with purulent exudate and surrounding erythema. He also has a widespread petechial rash.

His bloods are as follows:

  • WBC 9.6×109/l (3.6-11.0×109/l)
  • Neutrophils 9.1×109/l (1.5-7.5×109/l)
  • Haemoglobin 138g/l (130-180g/l)
  • Platelets 102×109/l (140-400×109/l)
  • CK 610 (40-320U/L)
  • CRP 252mg/l (<5mg/l)
  • Urea 15.0mmol/l (2.5-7.8mmol/l) Creatinine 283 mo/l (59-104 mol/l)

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