Case 55: Introduction

Case submitted by: ***
Case Published: ***

History of Present Illness (HPI)

clipboard

A 56-year-old woman with a past medical history of hypertension, obesity, and decompensated alcoholic liver cirrhosis presents with nausea, vomiting, and lethargy to the Emergency Department. She is hypotensive and encephalopathic requiring emergent intubation. She remains hypotensive despite fluid resuscitation and is started on norepinephrine. Broad spectrum antibiotics are initiated and she is admitted to the ICU for further management.

On day 3 of her ICU admission, she remains hypotensive requiring norepinephrine, and her urine output has decreased significantly. Nephrology is consulted. 

Click here for the physical exam!