Chapter 1: Chapter 1

A?i1-year-old woman is admitted from a nursing home with contusion, fever, and flank pain. She has a presumed urinary tract infection. On physical exam, temperature is 36.8 °C (101.8 °F), blood pressure is 66/50 mmHg, pulse rate is 125/min, and respiration rate is 24/min. Mucous membranes are dry, and there is costovertebral angle tenderness, poor skin turgor, and no edema. Hemoglobin concentration is 10.5 g/dL, leukocyte count is 15,600/uL and urinalysis reveals 50-75 leukocytes/ hpf and many bacteria/hpf. The patient has an increase anion gap metabolic acidosis. The patient is admitted to the intensive care unit and antibiotic therapy is started.