RT Book, Section
A1 Tsigrelis, Constantine
A1 Reboli, Annette C.
A2 Lee, Kiwon
SR Print(0)
ID 1101645941
T1 Common Infections in the ICU
T2 The NeuroICU Book
YR 2012
FD 2012
PB McGraw-Hill Education
PP New York, NY
SN 9780071636353
LK neurology.mhmedical.com/content.aspx?aid=1101645941
RD 2024/04/20
AB A  66-year-old  man  with  no  known  medical  history  was  admitted  after  a  fall  while  working  at  a  silo  on  his  farm.  On  physical  examination,  he  had  aphasia  and  right  upper  and  lower  extremity  weakness.  Computed  tomography  of  the  head  revealed  a  large  left  intracerebral  hemorrhage.  He  was  intubated  on  hospital  day  1  because  of  a  depressed  level  of  consciousness.On  hospital  day  7,  he  developed  fever  with  a  temperature  of  39.1°C  (102.3°F),  heart  rate  of  99  bpm,  blood  pressure  of  146/53  mm  Hg,  and  respiratory  rate  of  16  breaths/minute.  He  required  an  increase  in  inspired  oxygen  concentration  from  40%  to  60%.  He  had  a  moderate  amount  of  thick,  tan-colored  tracheal  secretions  from  the  endotracheal  tube.  He  did  not  have  diarrhea.  On  physical  examination,  there  were  decreased  breath  sounds  at  the  left  lung  base.  There  were  no  signs  of  exit-site  erythema  or  drainage  at  the  central  venous  catheter  and  right  radial  artery  catheter  insertion  sites.  A  urinary  catheter  was  in  place.  Peripheral  blood  leukocyte  count  was  17,600  cells/mm3.  Chest  imaging  revealed  a  new  left  lower  lung  field  opacity  (Figure  50-1).