()

(infection)

(host)

(infectious disease)

()
(infection)

()

(fever)

(pyrogen)

cytokine

(hyperthermia)

/
/

(SARS)
(Ebola
virus

48

98/50 mmHg
//38.2/124/28
97%

ConsciousnessE2M4V3
Isocoric pupil with equivocal light reflex
Conjunctivaemild pale
Sclerae: icteric
Clear breathing sound
No audible murmur
Abdomen

Distended with silent bowel sound

Shifting dullness (+)
Tenderness (?)

Leg edema (+)

CBC/DC
WBC
9800

Plt
78K

Seg
92%

GOT/GPT
68/88

Bil(T)
2.2

Na
132

BCS+e
BUN/Cre
30/1.6

Hb
10.2

K
3.6

Ammonia35 (9~33 umol/L)

One touch sugar88 mg/dL
Urinalysisno pyuria
CXR revealed no abnormal infiltration
Ascites routine
WBC420

L/N/M&H:45:50:5

lactulose

No space occupying lesion

WBC: 1200
L/N=8:92
Sugar level: 24 mg/dL
Total protein: 254 mg/dL

space
occupying

Gram stain
India ink

16

146/62 mmHg
//38.2/146/32
98%

Consciousnessclear
Isocoric pupil with prompt light reflex
Conjunctivaenot pale
Scleraenot icteric
Breathing sound decreased over RLL field
No audible murmur
Soft abdomen without tenderness
No peripheral cyanosis

CBC/DC
WBC
12400

Hb
14.2

Plt
182K

Seg
94%

BCS+e
BUN/Cre
21/0.98

GOT/GPT
22/18

Bil(T)
1.2

Na
136

K
3.8

air-bronchogram

(subcutaneous emphysema)

(deep neck infection )

(descending
necrotizing mediastinitis)
(empyema)

(
)

()

acute epiglottitisLudwigs
angina

(stridor)

()

(corrosive injury)

67

126/78 mmHg
//38.4/108/14
96%

Consciousnessclear
Isocoric pupil with prompt light reflex
Conjunctivaenot pale
Scleraenot icteric
Clear breathing sound
No audible murmur
Soft abdomen without tenderness
No peripheral cyanosis, no leg edema

CBC/DC
WBC
13200

Plt
224K

Seg
82%

BCS+e
BUN/Cre
26/1.26

Hb
13.2

GOT/Bil(T)
36/1.2

Urinalysisno pyuria

Na
130

K
3.6

()

(infected
thoracic aortic aneurysm, thoracic
mycotic aneurysm)
(salmonella
bacteremia,non-typhi)

()

(>90%)

()

38

()

(rash)

112/58 mmHg
//38.8/118/22
97%

ConsciousnessE1M3V2
Isocoric pupil with prompt light reflex
Conjunctivaenot pale, petechiae (+)
Scleraenot icteric
Clear breathing sound
Pan-systolic murmur over apex with axilla
radiation
Soft abdomen without tenderness
Peripheral rash (+)

CBC/DC
WBC
21200

Plt
112K

Seg
94%

BCS+e
BUN/Cre
34/2.68

Hb
10.2

GOT/Bil(T)
46/2.4

Na
138

K
3.2

Urinalysismicroscopic hematuria

(infective endocarditis)
(meningococcemia)
(rickettsial infection)

(infective
endocarditis)

70

118/68 mmHg
//37.8/128/22
95%

Consciousnessclear
Isocoric pupil with equivocal light reflex
Conjunctivaemild pale
Sclerae:not icteric
Clear breathing sound
No audible murmur
Abdomen

Distended with silent bowel sound

No muscle guarding

No leg edema
No rash

CBC/DC
WBC
10900

Hb
11.2

Seg
96%

Bil(T)
1.2

ALP
392

BCS+e
BUN/Cre GOT/GPT
30/1.8 64/48

Plt
158K

Na
135

One touch sugar284 mg/dL

ABGmetabolic acidosis
Urinalysisno pyuria, no ketouria

K
3.6

(liver abscess)
(klebsiella pneumoniae)

63

102/50 mmHg 80/46 mmHg

//36.8/118/26
98%

Consciousnessclear
Isocoric pupil with equivocal light reflex
Conjunctivaenot pale
Scleraenot icteric
Clear breathing sound
No audible murmur
Abdomen

Soft with normoactive bowel sound

Tenderness (+) over RLL, no rebounding pain
No flank knocking pain

No leg

angiomyolipoma

Psoas/Obturator sign

CBC/DC
WBC
7800

Hb
12.2

Seg
90%

BCS+e
BUN/Cre GOT
30/1.8 56

Plt
104K
Na
143

K
4.8

One touch sugar188 mg/dL

Ampicillin/Sulbactam + Clindamycin

//

(pyomyositis)

toxic shock syndrome

(pyomyositis)

Group A streptococcus
Staphylococcus aureus
Clostridium spp

C. perfringens

clindamycin

(abscess drainage)
(debridement)

41
B

37.8

148/86 mmHg
//38.4/128/30
97%

Consciousnessdisoriented
Isocoric pupil with equivocal light reflex
Conjunctivaenot pale
Sclerae:mild icteric
Clear breathing sound
No audible murmur
Abdomen

Distended with silent bowel sound

No tenderness/rebounding pain/muscle guarding

Bilateral lower leg edematous ecchymosis with

bullae formation

(necrotizing
fasciitis)
(aeromonas)


(necrotizing fasciitis)


Epidermis

Dermis

Erysipelas
Impetigo
Folliculitis
Ecthyma
Furunculosis
Cellulitis

Superficial fascia
Subcutaneous fat,
nerve, arteries, veins

Necrotizing
fasciitis

Deep fascia
Muscle

Myonecrosis (gas gangrene)


(necrotizing fasciitis)

(polymicorbial)

(vibrio spp)(aeromonas spp)


(necrotizing fasciitis)

crepitus

43

108/50 mmHg
//38/118/22
97%

ConsciousnessE2M4V3
Isocoric pupil with equivocal light reflex
Conjunctivaenot pale
Sclerae:not icteric
Clear breathing sound
No audible murmur
Abdomen

Soft with normoactive bowel souud

No tenderness

No leg edema
NO rash

CBC/DC
WBC
9600

Hb
12.2

Seg
84%

BCS+e
BUN/Cre GOT
30/1.2 26

Plt
114
CPK
110

Na
142

K
4.4

One touch sugar146 mg/dL

CXR revealed no abnormal
infiltration

SARS

(Fourniers gangrene)


(Fourniers gangrene)()

(polymicorbial)


(Fourniers gangrene)()

28

122/84 mmHg
//38.8/112/18
99%

Consciousnessclear
Isocoric pupil with equivocal light reflex
Conjunctivaenot pale
Scleraenot icteric
Clear breathing sound
No audible murmur
Abdomen

Soft without tenderness

No flank knocking pain

No rash

CBC/DC
WBC
10800

Hb
13.2

Seg
80%

BCS+e
BUN/Cre GOT
30/1.6 22

Plt
78K
Bil(T)
0.8

Na
140

Urinalysisno pyuria
CXR revealed no abnormal
infiltration

K
3.6

()

()

(meningococcemia)


(meningococcemia)()

Waterhourse-Friderichsen syndrome
purpura fulminans


(meningococcemia)()