Round 18 (Fatigue)

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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)