Cliniquiz

SEPSIS

Pallavi Ahluwalia
Associate Professor, Dept. of Anaesthesiology, Teerthanker Mahaveer Medical College, Moradabad, U.P. (India)
A 35 year old female, weighing 85 kg, 5 feet tall, with a history of poorly controlled insulin-dependent diabetes mellitus is admitted to hospital with fever,altered mental status and arm swelling, after cutting her hand while working outside, 24-hours prior to admission. On examination, the right arm was noted to have erythema, cutaneous gangrene and air in the soft tissue. Vital signs are respiratory rate 32/min, blood pressure 75/38 mmHg, mean arterial pressure
(MAP) 44 mmHg and heart rate 130/min. Her oxygen saturation (SpO 2) is 92% on room air. She appears to be disoriented and her laboratory work up reveals a blood glucose of 460 mg/dl (13.9 mmol/dl), white blood cell (WBC) count 23.4 x 10 3 /L, and hemoglobin 11.5 g/ dL

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