Round 18 (Fatigue)

CAUTION: THESE NOTES CONTAIN SPOILERS!!!











Case Introduction











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.











Initial Vitals











* Temp 101.2F* HR 122* RR 22* BP 110/90* O2 98%











Critical Actions











* 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











Final Diagnosis











Malaria











Tips and Tricks











* 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











Further Reading











Malaria (EMDocs)