Septic shock

Background
39 years malay lady ,NKMI, presented with sudden onset of loss
of conciousness, prior to LOC,
she had fever for 3 days, high grade a/w chills & rigor,
Headcahe, nausea & vomitting for 2days
Slurred speech
No URTI/ UTI symptoms
No LOA/LOW
Past medical history: no history of HTN/ DM/ Epilepsy
Personal history: housewife, married with 5 children
On Arrival GCS E3V1M5,
GM: 16.9
Hypotensive support by dopamine
Tachycardic ,Tachypneic ,T- 39.2 degree, Septic looking
On ABG noted : metabolic acidosis
7.27/38/25/17.5/-8.5 lactate 1.6
Urine ouput : 0.5cc/kg/hr
CT brain : No intracranial bleed
CXR: Clear lung field , on ascultation air entry equal.
UFEME : leucocyte +, ketone -ve, blood –ve , nitrate –ve
IV Ceftriaxone and IV Acyclovir started by medical.
IMP given by medical Septic Shock secondary to meningoencephalitis
Septic workout taken by medical team at ED
 Progression
C+S (04/12) result traced today : Growth of Stapylococcus
Coagulase negative, Enterococcus faecalis & E. coli.
No sensitivity yet.

Currently patient was nursed in ICU, latest plan is to continue

antibiotics, ventilator support and best supportive care until the
sensitivity of C+S is revealed.