Correct!
5. All of the above
The Systemic Inflammatory Response Syndrome (SIRS) is clinically defined as the presence of at least two or more of the following criteria: fever >38.0°C or hypothermia <36.0°C, tachycardia >90 beats/minute, tachypnea >20 breaths/minute, leukocytosis >12 X 109/l or leucopoenia <4 X 109/l. It is a manifestation of dysregulated inflammation and may be associated with both infectious processes and noninfectious processes such pneumonia, pyelonephritis, acute pancreatitis and burns. When SIRS is suspected it should prompt an evaluation for a septic infectious focus. Sepsis is a systemic inflammatory response to a confirmed or suspected infection. The development from SIRS to sepsis to septic shock represents a continuum with increasing mortality. Early treatment with broad-spectrum antibiotics and fluid resuscitation has been strongly related to increased survival.
Hospital Course
Despite broad-spectrum antibiotic coverage with vancomycin and piperacillin/tazobactam, the patient remained febrile although hemodynamically stable. Labs were notable for persistent severe leukocytosis, high eosinophil count, bandemia and rising liver enzymes. The erythematous rash progressed along his extremities and torso. Repeat blood and wound cultures were negative. Abdominal imaging including CT scanning of abdomen and pelvis showed no acute intrabdominal or hepatic pathology.
Which of the following diagnosis is/are a life-threatening skin condition? (click on the correct answer to proceed to the third of 4 panels)