A 85 yr old male presented with complaints of- Chronic bed ridden state and bed sores (4-5 months) , intractable Hiccoughs,Altered mentation and tachypnea since 5-6 days. He is a chronic tobacco chewer and k/c/o syst HTN. No h/o T2DM , ATT intake,jaundice , LOC, seizures....BP- 160/100, PR-130/min, sPO2 - 98% with O2 ,Temp - 100.9°F, RR- 34/min.....Discuss line of management...


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Patient is being treated on lines of Sepsis and MODS on broad spectrum antibiotics and pt is responding although he is having AKI (Urea -160, creat- 1.6).... and Hypernatremia (Na+ - 159)

ABG,SODIUM&POTASSIUM LEVEL,ketones,ECG. should be check out.,Looks like septicaemia,and multi organ failure picture.

In Chronic bed ridden old age, sudden altered sensorium one should think of aspiration pneumonia, and pulmonary embolism. And now hiccups, end organ damage like uremia and sepsis with multi organ failure. Put solid be evaluated for above clinical condition with car. Blood culture, D dimer, egg, echo etc.


acute delirium due to sepsis likely intractable hiccups ? due to cronic LRTI, associated CNS lesion

Its a case of septicemia...

It is a case of renal disease,acute or chronic renal failure, check upon renal parameters and ultrasound abdomen,ct abdomen Treatment don't over load with fluids, antibiotics,renal safe after parameters dialysis if condition worsens intubation and ventilatory support

Septicemia with multiorgan failure.

It's septicemia with multi organ failure

Sepsis with multiple organ failure

Pt. Should be treated on the line of multiple organ failure and septicemia

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