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Washington University Experience | MYELIN (IMMUNE-MEDIATED) | MS - Cerebral Hemispheres | 6A0 Case 6 History
Case 6 History ---- This 55 year old man with no significant past medical history presented to the emergency department in 4/2013 with complaints of difficulty breathing and sudden onset of shortness of breath overnight. He had experienced difficulty breathing for past week, nonproductive cough, and pain localized to his rotator cuff on the left side. He was initially treated with aspirin, nitroglycerin, insulin, azithromycin, ceftriaxone, fluids, and pain medication. He was initially given oxygen via nasal cannula but was subsequently intubated for worsening respiratory distress. Laboratory values were significant for a low WBC count (1.5) with 22% neutrophils and 16% bands, elevated glucose (371), elevated troponins, lactic acidosis, coagulopathy, and elevated D-dimer (7.88). Blood cultures were positive for MRSA. A chest radiograph showed confluent infiltrates throughout the left lung compatible with pneumoniae and mild right perihilar infiltrates. The patient was admitted to the intensive care unit for sepsis and multiorgan system failure due to presumed community acquired pneumonia. He was pancultured and initially antibiotics were started. His condition continued to worsen and he had multiple episodes of cardiopulmonary arrest requiring resuscitation. Prior to his death he failed to regain spontaneous circulation despite maximum resuscitative efforts. Of note, no imaging of his head/brain was performed during his hospital stay.
