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Clinical Crossroads Update
July 4, 2012

Update: A 47-Year-Old Woman With an Indwelling Intravenous Catheter and Sepsis

JAMA. 2012;308(1):82. doi:10.1001/jama.2012.6665

In a Clinical Crossroads article published in April 2011,1 Derek C. Angus, MD, MPH, FRCP, discussed the pathophysiology, management, and treatment of sepsis. The patient, Ms C, was a 47-year-old woman with short gut syndrome and an indwelling intravenous catheter who developed sepsis due to a central line infection. Ms C had a history of Gardner syndrome treated with intestinal resection and needed lifelong parenteral nutrition; she had had multiple episodes of sepsis. On this occasion, she had symptoms of fatigue and nausea, lower abdominal pain, hip pain, and muscle pain; results of a blood culture drawn at home by a visiting nurse were reported positive and Ms C was brought to the hospital, where she was treated in the intensive care unit for sepsis. She improved by hospital day 3. Ms C was concerned about developing a “tolerance” to vancomycin; she wondered if there was any research being done on “stronger” antibiotics.

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