Question

A 70-year-old man presents to the emergency department with a 2-day history of fever, chills, cough, and right-sided pleuritic chest pain. On the day of admission, the patient's family noted that he was more lethargic and dizzy and was falling frequently. The patient's vital signs are: temperature, 101.5°F; heart rate, 120 bpm; respiratory rate, 30 breaths/min; blood pressure, 70/35 mm Hg; and oxygen saturation as measured by pulse oximetry, 80% without oxygen supplementation. A chest radiograph shows a right lower lobe infiltrate.

This patient's condition can best be defined as which of the following?
(A) Multi-organ dysfunction syndrome (MODS)
(B) Sepsis
(C) Septic shock
(D) Severe sepsis
(E) Systemic inflammatory response syndrome
(SIRS)

Answer 1

The patient's symptoms and clinical signs are indicative of septic shock, characterized by infection, hypotension, hypoxemia, and end-organ dysfunction.

Step-by-step explanation:

The condition described indicates the patient is suffering from septic shock. This is shown by the patient's symptoms of fever, chills, cough, and pleuritic chest pain combined with the presence of hypotension (blood pressure 70/35 mm Hg) and hypoxemia (oxygen saturation 80% without oxygen supplementation). Furthermore, the patient's altered mental state (lethargy, dizziness, and increased frequency of falls), as reported by his family, points to end-organ dysfunction, which is a typical feature of septic shock. The findings of an infiltrate in the right lower lobe of the lung on the chest radiograph corroborate with the clinical presentation of an underlying infection that has progressed to septic shock.