posted in Clinical Forum
A 72-year-old lady with a history of lung cancer and hypertension comes to the ER with diarrhoea that has been going on for 1 to 2 weeks. Except for a pulse rate of 97 beats per minute, a white blood cell count of 22,000/uL, and blood urea nitrogen (BUN)/creatinine 101/4.7 mg/dL (Systemic inflammatory response syndrome [SIRS] criteria >90 beats/min), the patient's vital signs are normal. However, her legs are mottled and discoloured, and her blood pressure is slightly low (Figure).
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