Presentation -- Fever, Purpura and Hypotension


GENERAL APPEARANCE: Plethoric white male with generalized purpura
HEENT: Edematous eyelids, swollen shut, spontaneous eye movements with conjugate gaze. The entire face is purpuric.
LUNGS: Intubated with clear and equal breath sounds
CARDIAC: Tachycardia
ABDOMEN: Firm, distended, and diminished bowel sounds, purpuric skin lesions
EXTREMITIES: Mild diffuse edema and purpuric discoloration of bilateral upper and lower.
NEUROLOGIC: Nonresponsive with occasional spontaneous eye and head movements

Enroute to the UPMC, the patient's blood pressure dropped to 50 mm Hg/palpable. He was stabilized in the ED with norepinephrine and dopamine. He received four units of type O blood. Penicillin G, IV calcium chloride, and solumedrol were also administered. He was stabilized and sent to the MICU.

Hospital Course


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