An HIV positive male, admitted to the ICU with septic shock secondary to lobar pneumonia, is being mechanically ventilated. After 2 days of IV ceftriaxone, trimethoprim-sulfamethoxazole, and erythromycin, his fever has resolved. Blood cultures are positive for S. pneumoniae. SpO2 is 92% on room air and BP is 80/40 mm Hg, despite adequate fluids and 2 mcg/kg/min of norepinephrine. Fuher examination reveals warm skin and full peripheral pulses. What is the next best step in management?
An HIV positive male, admitted to the ICU with septic shock secondary to lobar pneumonia, is being mechanically ventilated. After 2 days of IV ceftriaxone, trimethoprim-sulfamethoxazole, and erythromycin, his fever has resolved. Blood cultures are positive for S. pneumoniae. SpO2 is 92% on room air and BP is 80/40 mm Hg, despite adequate fluids and 2 mcg/kg/min of norepinephrine. Fuher examination reveals warm skin and full peripheral pulses. What is the next best step in management?
💡 Explanation
An HIV positive male, admitted to the ICU with septic shock secondary to lobar pneumonia, is being mechanically ventilated. After 2 days of IV ceftriaxone, trimethoprim-sulfamethoxazole, and erythromycin, his fever has resolved. Blood cultures are positive for S. pneumoniae. SpO2 is 92% on room air and BP is 80/40 mm Hg, despite adequate fluids and 2 mcg/kg/min of norepinephrine. Fuher examination reveals warm skin and full peripheral pulses. What is the next best step in management?
✓ Correct Answer: B. Cosyntropin stimulation test followed by hydrocoisone 100 mg IV every 6 hours
📤 Share this MCQ
Share Card Preview
👆 1080x1080 square card — fills the full width in WhatsApp and Telegram