A 28-Year-Old Man Presents with a Steadily Worsening Multiorgan Illness, Fever, and Profound Malaise

Introduction. A 28-year-old previously healthy man presents with a steadily worsening multiorgan illness characterized by fevers and profound malaise.

Patient history. Although previously healthy with no major medical diagnoses or required medications, the patient has been ill for approximately 2 weeks, with symptoms severe enough to prevent him from working at the auto repair shop where he is employed as a mechanic.

The patient denies drug use but occasionally drinks alcohol on weekends. He does not smoke and has not recently traveled.

Physical examination. The patient’s physical examination reveals an ill appearing young man with vital signs of fever 39.4 °C, pulse 108 beats per minute, respirations 16/min, and BP 108/68 (Table 1). Several examiners felt that both liver and spleen edges were palpable below the rib cage with inspirations. The remainder of the intake examination was negative.

A battery of laboratory findings revealed an abnormal complete blood count, among other results (Table 2). Based on the physical examination and laboratory test results, the patient was admitted overnight to the intensive care unit (ICU) for further evaluation and treatment.

Table 1. Physical examination findings

Table 2. Laboratory test results