Septic Report Sample: Fill & Download for Free

There is a story, perhaps apocryphal, about an Avon lady who was “working” an apartment tower. Stepping into the elevator to make her descent to the lobby, she suddenly was overcome with the most compelling intestinal cramps, and loudly emitted something almost 3-dimensional, which filled the car with an odor reminiscent of a country abattoir on a hot summer afternoon, mingled with the heady aroma and tang of an over-flowing septic tank.Thinking quickly, she grabbed from the depths of her sample bag a small aerosol can of pine fragrance (a new Avon item for refreshing automobile interiors) and liberally sprayed the air and walls around her.As misfortune would have it, the car stopped about midway, in answer to another call.In stepped a disheveled gentleman, whose ruffled clothing, hobbling gait, bloodshot eyes and rattling breath clearly indicated someone who had imbibed too much the night before. However, his immersion into the cloying atmosphere of the car momentarily aroused him enough to wonder exactly what ring of Hell he had entered. He leaned heavily against the back wall, moaning gently.But the Avon lady, hoping to cover the vile contaminants with conversation, inquired brightly, “What an interesting smell. What do you think that is?” Evidently, she hoped for a report of the uplifting scent of a primeval hemlock forest.But the bedraggled gent, now barely able to stand, could only huskily reply, “I dunno, lady…smellz to me like someone shit a Christmas tree.” The door opened to the lobby, and the two went their separate ways.Surely, she was the worst possible company on an elevator.

How many rounds of antibiotics will a doctor try before sending for cultures?It’s important to distinguish those infections that are clinically significant, i.e., severe enough to require hospitalization and/or are potentially life-threatening or have the potential to cause significant and lasting damage from something that is “going around” in a community. A “fever of unknown origin” is generally approached differently than something that occurs commonly in a given patient population and is known to be self-limiting. Certain infections such as otitis media, sinusitis, a simple wound infection or tonsillitis may be treated empirically with a broad spectrum antibiotic with a high likelihood of success. It’s also important to differentiate bacterial infections from those caused by viruses—the formulary of anti-viral drugs is vastly more limited than anti-bacterials, and they are prescribed under very limited circumstances. The question also presumes we’re dealing with a developed country with a robust health care system. Because of the litigious climate in the U.S., most physicians are reluctant not to prescribe antibiotics in circumstances where they’re really not indicated, a practice that is appropriately criticized and is a major cause of the emergence of antibiotic resistant pathogens.Any physician, whether an infectious disease specialist or not, who suspects a clinically significant infection or septic condition won’t prescribe antibiotics until appropriate cultures have been taken. That includes blood, urine, sputum, wound swabs or whatever other source may be indicated at the time. It takes literally a few minutes to take the full spectrum of culture samples, so the delay shouldn’t be onerous. Starting antibiotics precipitously without appropriate culture and sensitivity results will skew subsequent culture results and would delay appropriate antibiotic coverage or make it impossible. AFTER all possible sources have been cultured, then empiric coverage with broad spectrum antibiotic(s) may be started since culture/sensitivity reports typically take 48–72 hours to be reported. Once culture results are available, the antibiotic(s) prescribed can be adjusted accordingly.

This is a pretty long read, I can't seem to shorten my stories.It was finally Friday and we were planning a small get together at our quarter, with a bonfire and a barbecue and some Rum to thaw our chilled bones at the middle of the winter. I was not on call and planned on spending the evening listening to some cool jams and just enjoy the company.First, a little background. This incident took place in a really secluded remote hospital, literally located in the middle of the jungle. The government hospitals in Nepal which are located in such remote places do have quarters for us staff to live in nearby the hospital, so we can attend to anything, anytime.This is the aerial view of the hospital where I worked. It's called Amppippal hospital. And yes, it is a bit isolated and had no concrete road access.The chicken was getting barbecued and we were swapping stories when my colleague got called in. Usually people in these remote parts of the country don't come to the hospital unless it is something really really bad. When he returned, he told us that it was a case of Ludwig's Angina(An acute fulminant infection of the floor of the mouth which may lead to collection of pus in the base of the mouth.)This is a case of Ludwig's Angina. Image taken from Google. Read more on Ludwig's Angina : Ludwig's angina - Wikipedia.My colleague had admitted her on intravenous antibiotics as the patient could not afford to go to higher centre for treatment and sent for investigations that we could do in our centre.We discussed this case with our General Physician and our course of action for her was to see if it improves with antibiotics till the next day. If the swelling increases, we planned to drain the pus under anesthesia. Since it was a clear cut spot diagnosis for a young lady of around 20 years of age and previously seemingly healthy, we didn't ponder much on it and started on our barbecue dinner.We were halfway through the dinner when he got called as the reports were sent in and it was really really wrong. Her blood sugar was through the roof, it came around 450mg/dl (I don't remember the exact number. Normally it should be less than 200 mg/dl even for a random sample.) We finished our meal within the matter of minutes and all of us, my colleague and me as medical officers and our GP went in to see the patient.She seemed delirious with fever, sweating profusely. Her labs that we could do in that setting showed that she might be going septic. We asked what set this off because when she came in around a couple of hours ago, she didn't seem that bad and why was her random blood sugar through the roof.She had come in with her mother in law who did not know anything. And from what we could garner, the patient was a Muslim girl who had run off with her son, who was Hindu and they were both living in Kathmandu till a week ago when her son left the country to go to Gulf country for a job. Since then her Muslim daughter in law was staying in their home, she said all that with such disdain that we knew, this inter-religion marriage was not accepted in that household and she didn't really care about her daughter in law.We asked the patient and despite her state, she told us in her muffled voice that she was suffering from Type one Diabetes and was on Insulin. She had stopped using Insulin since there was no refrigeration in her new home with her MIL and she didn't want them to know that she was diseased and using injectable medication. She wanted her MIL to think she was healthy and deserving of her son.Plus she had come to the hospital around two days ago for dental extraction and had lied to the dentist in our hospital about her diabetes and had gotten her molar removed which had precipitated her condition.We sent for urinary ketones as soon as possible which came back with a whooping of 3+. She was going into Diabetic Ketoacidosis (DKA) whose treatment is fluids, electrolytes and Regular Insulin. We didn't have Regular Insulin then because it was very rare to get a case of DKA in such a rural setting and it's an expensive medicine to keep in store, needing refrigeration at all times. We asked the MIL to take her to a higher centre because DKA is a life threatening condition and there was nothing we could do about it in our setting.But the MIL refused to do so because she was alone in the house too and didn't have enough money to take her anywhere. We started her on Fluids and tried correcting her electrolytes the best way we could and in the meantime, we pulled money from the Social Service Unit and got an ambulance ready. By the time we got all that ready, she was getting worse, her breathing had started becoming laborious because the swelling was compressing onto her trachea. We intubated her and sent our seniormost paramedic with her to a tertiary care hospital for ICU care.We had already talked to the people in the tertiary hospital regarding the case and they were ready to receive her. But by the time they reached the hospital, it seemed it had been a little too late, the buildup of acid in her body was too much. She succumbed to the condition a couple of days later in the ICU.If she had told the dentist that she was diabetic but not under any medication, her dental extraction would have been delayed till her blood sugar level were normalised. And she wouldn't have to go through all that ordeal and lose her life. But she lied about her condition which proved to be fatal.So please don't ever lie to your doctor, ever. Especially if you have a chronic condition and you're taking medication for it. Every little detail matters.