Pearls from Dr. David Chong

Septic shock due to severe skin/soft tissue infection in an HIV-infected patient with KS-associated lymphedema


  • Necrotizing fasciitis: skin/soft tissue infection (SSTI) extending beyond epidermis/dermis/fat into fascia +/- muscle --> Poly- or mono-microbial (GAS, S. aureus, V. vulnificus-->immunocompromised/iron overload, C. perfringens-->myonecrosis) 

    Posted 05/29/16 03:37:52 PM by Matthew Cummings

  • Sepsis-3 definitions (Feb 2016): re-conceptualize sepsis as infection-related organ damage (SOFA), thus “severe sepsis”  no longer included

    Posted 05/29/16 03:39:00 PM by Matthew Cummings

  • Resuscitation fluid: colloid vs. crystalloid

    Posted 05/29/16 03:39:45 PM by Matthew Cummings

  • For further reading...

     LRINEC score for diagnosis of necrotizing SSTI
    Necrotizing SSTI: clinical review
    2016 Sepsis-3 definitions (JAMA)
    SAFE trial (NEJM 2004)
    SPLIT trial (JAMA 2015)

    Posted 05/29/16 03:44:48 PM by Matthew Cummings

  • Triage Morning Report - Meningitis and subglottic stenosis


  • For chronic thromboembolic pulmonary disease, CTA for PE is not a good test - V/Q scan is better and preferred

    Posted 12/12/16 11:18:39 AM by Anna Krigel

  • SOFA Severity Score - Sequential Organ Failure Assessment

    Posted 12/12/16 11:30:09 AM by Anna Krigel

  • CT head before LP in Adult Patients with Suspected Meningitis needed when...

    Posted 12/12/16 11:33:00 AM by Anna Krigel

  • Empiric Antibiotic Coverage for Bacterial Meningitis

    Posted 12/12/16 02:30:40 PM by Anna Krigel

  • Mallampati classification - provides an estimate of space available for oral intubation

    Posted 12/12/16 02:32:57 PM by Anna Krigel

  • Subglottic stenosis - most common manifestation of tracheobronchial granulomatosis with polyangiitis (Wegener's granulomatosis)

    Posted 12/12/16 02:37:10 PM by Anna Krigel

  • For further reading...

    Dexamethasone in Adults with Bacterial Meningitis (NEJM)
    Sepsis-3 (JAMA 2016)

    Posted 12/12/16 02:40:27 PM by Anna Krigel

  • 55yoF w/ L pleural effusion found to have b/l PEs and DLBCL


  • Most common cause of asymmetric pleural effusion is heart failure, most commonly right sided.  

    Posted 07/05/17 10:16:27 AM by Emily Miller

  • If see a unilateral L sided pleural effusion think : 1) cancer 2) pancreatitis 3) post-pericardotomy syndrome

    Posted 07/05/17 10:17:09 AM by Emily Miller

  • Albumin is not a great marker for nutritional status because half life is 30-40 days.  Albumin is a good marker for inflammation.  if total protein is normal, but albumin is low think that patient may be losing albumin.  

    Posted 07/05/17 10:18:28 AM by Emily Miller

  • 62YOF p/w hypoxia, cyanosis after TEE, found to have methemoglobinemia


    Mechanical Ventilation


    Sepsis Update 2018


    29yoF w/cough, fevers, SOB, developed ARDS and found to have fluA


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