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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 340:1819-1826 June 10, 1999 Number 23
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Case 17-1999— A 42-Year-Old Asplenic Man with Gram-Negative Sepsis
Jeffrey Parsonnet, and James Versalovic

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Presentation of Case

A 42-year-old asplenic man was admitted to the hospital because of gram-negative sepsis.

The patient had been well until one week earlier, when his left upper teeth began to ache. Four days before admission, he had abdominal cramps and two loose stools. The next morning, he awakened with diffuse aches, especially in the arms, legs, and lower back. After a small breakfast, he vomited several times and then had shaking chills with increasing fever. He was admitted to another hospital. His temperature was 40°C. The results of a physical examination were otherwise normal. The urine was normal. Laboratory tests were . . . [Full Text of this Article]

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Dr. Jeffrey Parsonnet's Diagnosis

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