Hey, folks, just a quick reminder that this podcast is not meant to be used for medical advice, just good old-fashioned education.

Welcome back, Clinical Problem Solvers, to part two of our two-part series with Dr. Lisa Winston as our

discussing in Dr. Lev Malaventic as our presenter. Lev, take it away. He was admitted to the hospital

and started on vancomycin and pippercillantazobactam for sepsis without a clear source.

On subsequent hospital days, the patient's leukocytosis and fever persisted, so he was

switched from pptazzo to meropenum.

Blood cultures and acidic fluid cultures were negative.

CT abdomen pelvis was notable for large volume of cytos.

The thoracic portion of the abdominal CT showed multifocal right middle lobe consolidations.

TTE was without vegetations.

Fuconazole was added for empiric fungal coverage.

All right.

So not surprisingly, given that he had presented with fever previously, and a clear diagnosis was

not made.

We are not initially making a clear diagnosis here either. But, so I'll just make a few

comments about this next Aliquot here. One is the antibiotics he was started on the vancomycin

and peppercillin-tazobactam. And so maybe I can do this

just one time and throw it, throw it out to you guys. What do you think about vancomycin and

peppercilent tasobactam for this particular patient. Am I allowed to do that just once?

You're the boss here, Lisa. You can do it as many times as you want.

But because I'm sure you have thoughts about it.

So I can take it.

...