A 61-year-old man with a history of hypertension presented to the emergency department with a 1-day history of fever, dyspnea, and generalized weakness. His vital signs were temperature, 38.4°C (101.1°F); blood pressure, 94/40 mm Hg; heart rate, 116/min; and respiratory rate, 26/min. He was diaphoretic and had poor dentition. A soft S1 was present on cardiac examination, and crackles were auscultated in basilar lung fields bilaterally. Three sets of blood cultures from different sites were obtained. Cardiology, cardiac surgery, and infectious disease physicians were consulted. A bedside transthoracic echocardiogram was performed, the patient was transferred to the intensive care unit, and a transesophageal echocardiogram was obtained (Figure 1).
Oh N, Downey P, Ardehali A. A Febrile, Hypotensive Patient With Bilateral Lung Crackles. JAMA. Published online May 20, 2019321(24):2460–2461. doi:10.1001/jama.2019.6546
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: