A 71-year-old man presents as triage level 1 with fever and confusion. BP is 78/42 mm Hg after 30 mL/kg crystalloid, lactate is 5.5 mmol/L, urine

Question

A 71-year-old man presents as triage level 1 with fever and confusion. BP is 78/42 mm Hg after 30 mL/kg crystalloid, lactate is 5.5 mmol/L, urine microscopy suggests infection, and creatinine has doubled from baseline. Which of the following is the most appropriate next step in management?

Accepted Answer

Start norepinephrine, broad-spectrum antibiotics, cultures, and ICU admission

Answer

Use antipyretics alone until lactate normalizes

Answer

Administer furosemide for renal failure

Answer

Wait for urine culture before antibiotics

Answer

Give oral ciprofloxacin and discharge

Urosepsis with septic shock — ABEM Board MCQ

A 71-year-old man presents as triage level 1 with fever and confusion. BP is 78/42 mm Hg after 30 mL/kg crystalloid, lactate is 5.5 mmol/L, urine microscopy suggests infection, and creatinine has doubled from baseline. Which of the following is the most appropriate next step in management?