This the recap of the 2nd of our 2 "Sepsis Smackdown" cases.  Several weeks back, we presented to you the case of Lucy, a 79 yo female resident of a nursing facility presenting to your busy community ED with reported altered mental status.  She's unable to provide you with a meaningful history but you piece together she's been acting abnormally at the nursing facility over the course of the past several days at the nursing facility and is now febrile, tachycardic, and hypotensive.  In your testing, you find her to have a UTI, begin her resuscitation and admit her to the hospitalist and MICU.  While waiting for a bed, she continues to be poorly responsive to your resuscitation...

Below you will find the recap of the 1st case in our Sepsis Smackdown case series.  Several weeks ago, we posed a clinical scenario followed by a series of questions.  As a refresher the case was that of Linda, a 79 yo female resident of a local nursing facility who arrives to your busy community ED with altered mental status, hypothermia, tachycardia, hypotension, and along history of multiple complicated UTI's. You begin your work up and find her to again have a likely UTI with a urine dipstick with large leukocyte esterase, pH 5.5, 20 protein, negative nitrite.