Abstract
A 57-year-old man with a past medical history of hypertension and hyperlipidemia was brought to the emergency department by ambulance with severe sepsis. He had no previous history of head trauma and surgery. We immediately started a set of treatments for severe sepsis, including fluid resucitaton, but his blood pressure was refractory, and he was transiently suffered from cardiac arrest. His initial and secondary laboratory tests revealed the rapid development of disseminated intravascular coagulation (DIC) during the 2 hrs after arrival. The patient was admitted to the ICU and intensively treated with multidisciplinary treatment, including meropenem, hydrocortisone and gamma globulin. However, he died 22 hrs after arrival. Subsequent autopsy revealed that the patient was suffered from severe septicemia, and bacterial meningitis caused by Staphylococcus aureus and Pseudomonas aeruginosa. Although emergency physicians or intensivists do not frequently have a chance to examine adult patients with bacterial meningitis, we have to aware that some of these patients are complicated with fluminant septic shock and DIC.
