{"pk":359,"title":"No Room for Error: Empiric Treatment for Fulminant Pneumonia","subtitle":null,"abstract":"Early antibiotic administration is critical in cases of sepsis and severe community-acquired pneumonia, which is frequently due to \nStreptococcus pneumoniae\n, \nStaphylococcus aureus\n, \nLegionella\n species, or influenza. We describe the case of a 29-year-old previously healthy man who presented to an urban emergency department (ED) in the North Central U.S. with fever, hip pain, severe hypoxemia, and diffuse pulmonary infiltrates. He was intubated and received piperacillin/tazobactam, levofloxacin, vancomycin, and oseltamivir; given his fulminant presentation and predicted high mortality, doxycycline, methylprednisolone, and amphotericin B were also administered empirically in the ED. A respiratory culture eventually grew \nBlastomyces dermatitidis\n, and the patient survived. Severe acute respiratory distress syndrome due to fulminant pneumonitis carries a high mortality. Faced with this scenario and no room for error, it is important that the emergency physician cover for all possible pathogens, including zoonotic bacteria and endemic fungi.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3w4336k1","frozenauthors":[{"first_name":"Matthew","middle_name":"E","last_name":"Prekker","name_suffix":"","institution":"Hennepin County Medical Center, University of Minnesota Medical School","department":"None"},{"first_name":"Stephen","middle_name":"W","last_name":"Smith","name_suffix":"","institution":"Hennepin County Medical Center, University of Minnesota Medical School","department":"None"}],"date_submitted":"2017-03-13T21:00:01Z","date_accepted":"2017-03-13T21:00:01Z","date_published":"2017-03-13T07:00:00Z","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/359/galley/125/download/"}]}