Skip to main content
WardSpace
Specialties

Infectious Diseases

Fever, cultures, antimicrobials, and source thinking.

Presentations

Fever in the hospitalShock & hypotensionAcute diarrheaDysuriaHeadacheRash on the ward

Ward cases

The 03:00 page

Cross-cover: a post-op medicine boarder spikes a fever, and her pressure follows.

A hot red leg that is not getting better

A 58-year-old is on day four of intravenous antibiotics and the leg looks the same.

Headache, fever, and the lights hurt

A 20-year-old student arrives febrile and confused, hiding her eyes from the examination lamp.

Fever three weeks after the flight home

A 31-year-old back from visiting family in West Africa has had rigors every evening for four days. Tonight he is confused.

Interpretation drills

LabsFever, hypotension, and a lactate to followBlood gasSeptic and breathing hardFluidBacterial CSFFluidViral CSFFluidEmpyema: pH 7.08UrineThe catheter dipstick trap

Medications

drugVancomycindrugCeftriaxone

From the library

Frontal chest radiograph with dense consolidation at presentation of community acquired pneumonia
Community pneumonia at presentation: dense consolidation with air bronchograms. The film to keep, because the follow-up only means something beside it.Jtechr, via Wikimedia Commons · CC BY-SA 3.0 · source
Frontal chest radiograph of the same patient after antibiotic treatment, consolidation largely cleared
The same patient after antibiotics: the consolidation has largely cleared. Radiographic resolution lags clinical recovery by weeks, which is why the follow-up film waits.Jtechr, via Wikimedia Commons · CC BY-SA 3.0 · source
Gram stain showing gram positive lancet-shaped diplococci of Streptococcus pneumoniae
Gram positive diplococci, lancet shaped, in pairs: Streptococcus pneumoniae. In cerebrospinal fluid this picture names the organism hours before the culture does.Arnold Kaufman, via Wikimedia Commons · CC0 · source
Gram stain showing purple gram positive cocci in clusters beside pink gram negative rods, with a scale bar
Both answers on one slide: gram positive cocci in clusters (purple) and gram negative rods (pink). The colour is the cell wall; the shape and grouping are the organism.Y tambe, via Wikimedia Commons · CC BY-SA 3.0 · source