(精编)【持续性肾脏替代治疗CRRT，Non-infectious causes of fever in ICU.pptVIP

A patient with MDS/AML, fever, resp distress and nodular infiltrates ABX: Vanco (2/12-2/25, 3/9-now) Pip-tazo (2/12-2/15, 3/9-now) Voriconazole (2/21-2/28, 3/9-now) Acyclovir 400mg PO BID (2/2-now) Fluconazole 400mg PO daily (2/3-2/22; 2/28-now) Metronidazole (3/9-now) Cefepime (2/24-3/5) Bactrim (2/22-2/24) Meropenem (2/19-2/24) Gentamicin (2/19-2/22) Cipro (2/12-2/21) Imipenem (2/15-2/19) GRAM STAIN: MODERATE WBCS FEW EPITHELIAL CELLS MANY GRAM NEGATIVE RODS MODERATE GRAM POSITIVE COCCI CULTURE RESULTS: MODERATE PSEUDOMONAS AERUGINOSA ANTIBIOTIC SUSCEPTIBILITY TEST RESULTS: PSEUDOMONAS AERUGINOSA : SUSC INTP AMIKACN 4 S MCG/ML CIPROFLOXACIN =4 R MCG/ML GENTAMICIN =16 R MCG/ML IMIPENEM. 8 I CEFEPIME 8 S PIP/TAZO 32 S MCG/ML A patient with MDS/AML, fever, resp distress and nodular infiltrates D 2 Broviac D 3 idarubicin/ cytarabine D11 Diarrhea, F/C D12 GNR bacteremia Pip/tazo/vanco/cipro D19 Broviac removed D21 intubated D20 BAL negative, voriconazole added; serum galactomannan sent; D22 Bactrim added D23 negative smears BAL, pressors D24 renal insuff D26 off pressors, extubated D27 negative galactomannan D35 resp failure, MICU D38 death A patient with MDS/AML, fever, resp distress and nodular infiltrates Non-infectious etiologies: Acute leukemia Pulm infarcts, emboli Pneumonitis without infection Untreated infection? Galactomannan vs β-1,3-D-glucan Galactomannan vs β-1,3-D-glucan Blood and fever Transfusions Transfusion reactions Blood where it doesn’t belong Thrombosis and fever CVA and fever MI and fever A patient 19 days post-op from wedge biopsy of right lower lobe 79 y/o male with CAD, severe AS, a. fib on warfarin developed hemoptysis CT scan showed RLL infiltrate vs mass A patient 19 day