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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 340:869-876 March 18, 1999 Number 11
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Case 8-1999— A 28-Year-Old Man with Gram-Negative Sepsis of Uncertain Cause
Paul E. Farmer, and Fiona M. Graeme-Cook

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Presentation of Case

A 28-year-old man was admitted to the hospital because of gram-negative sepsis.

The patient had been in excellent health until three weeks earlier, when malaise developed. Ten days before admission, he attended a wedding. The next day he had fatigue, anorexia, and malaise, which waxed and waned. Four days before admission, his temperature rose to 40.6°C, with rigors, sweats, and difficulty concentrating. Two days later, the patient had a severe occipital headache.

One day before admission, the patient came to the emergency department at this hospital. The temperature was 38.7°C, the pulse was 120, and the respirations were 20. The . . . [Full Text of this Article]

Differential Diagnosis

Clinical Diagnosis

Dr. Paul E. Farmer's Diagnosis

Pathological Discussion

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