A 54-year-old man with type 2 diabetes mellitus and psoriatic arthritis on monoclonal antibody therapy presents with a two week history of progressive headache, nausea and vomiting, fever and an unsteady gait. He has had a recent episode of sinusitis which was treated with oral antibiotics.
You are asked to admit a 48-year-old lady who received ablative chemotherapy and an allogeneic bone marrow transplant two weeks ago for acute myeloid leukaemia. She has become progressively more dyspnoeic in the ward. A chest XRay demonstrates a diffuse pulmonary infiltrate.
A 63 year old woman was admitted to the Intensive Care Unit 4 days ago. She has suffered a cardiac arrest in the community, was resuscitated by Ambulance Officers and was treated with urgent cardiac angiography and stenting of a significant left main coronary artery lesion.
Data sets provided for interpretation included
a) a Gram positive bacilli bacteremia with neurological symptoms and signs - Listeriosis
b) an antibiogram of a multiresistant Gram negative bacillus in a patient on meropenem
A 72 year old diabetic male is admitted to the Intensive Care Unit with a history of loin pain. He is febrile, tachycardic, hypotensive and tachypnoeic but stabilizes after fluid resuscitation and vasopressor infusion.
A previously well 27 year old woman has been admitted to ICU following an appendectomy for a perforated appendix. Her Pulse is 130/min, BP 65/30 despite six litres of crystalloid resuscitation. Her SpO2 is 90% on FIO2 of 0.7, PEEP 10 cm H2O, SIMV.
An 18-year-old man presents to hospital two days following completion of induction chemotherapy for acute myeloid leukaemia. His main complaint is central abdominal pain. He is tachycardic at 120/min and his systolic blood pressure is 70mmHg. His temperature is 38.7 C.
Clinical case: Material presented regarding management of a man with a past history of diabetes, ischaemic heart disease and chronic lymphatic leukemia who presented with hours of severe abdominal and back pain and hypotension: biochemistry (pseudohyperkalaemia), microbiology (oxidase positive no