Round 18 (Fatigue)

Summary: <br> CAUTION: THESE NOTES CONTAIN SPOILERS!!!<br> <br> <br> <br> Case Introduction<br> <br> <br> <br> You are working a shift at EM Clerkshift General when a 20yo female accompanied by her mother checks into the ER with chief complaint of fatigue.<br> <br> <br> <br> Initial Vitals<br> <br> <br> <br> * Temp 101.2F* HR 122* RR 22* BP 110/90* O2 98%<br> <br> <br> <br> Critical Actions<br> <br> <br> <br> * Obtain travel history in patient presenting with fever of unknown source* Perform sepsis workup and treatment in patient with at least 2 SIRS criteria* Order thick/thin peripheral blood smear* Consult ID* Admit patient<br> <br> <br> <br> Final Diagnosis<br> <br> <br> <br> Malaria<br> <br> <br> <br> Tips and Tricks<br> <br> <br> <br> * Always obtain detailed history in patient presenting with fever without obvious source (travel history for infectious agents, IV Drug history for endocarditis, etc)* Utilize CDC.org to determine which infections are endemic to each country that your patient traveled in<br> <br> <br> <br> Further Reading<br> <br> <br> <br> Malaria <a href="http://www.emdocs.net/em3am-malaria/">(EMDocs)</a><br>