Date: 16 Mar 2010
Figure. CT abdomen, click Read More for a bigger image
A 62 year-old woman was admitted to the ICU for septic shock and ARDS. She was intubated and started on empirical antibiotics: Maxipime 1G Q8H + Klacid 500mg BD + Tamiflu 75mg BD. Endotracheal aspirate was negative for PCR of H1N1; AFB smear and bacterial culture.
Aspiration pneumonia after recent stroke was suspected, and was supported by a recent infarct at upper pons as shown up by CT Brain. Antiviral was taken off on day 3, and all antibitoics were taken off at day 7. Soon after extubation on day 8, she developed another episode of septic shock leading to multi-organ failure. CXR after the second intubation was essentially normal, and urine/ endotracheal aspirate grew nothing. Abdomen was soft but distended, and rectal examination showed loose watery stool. Blood culture grew ESBL E. coli and multi-drug resistant Acinetobacter baumanii. Contrast CT abdomen was performed in order to localize the site of sepsis, and a typical image was shown below
What was the cause of septicemia?
{morfeo 64}
Answer available!!!