Infectious Diseases I

Patient Cases

D.L. is a 69-year-old woman admitted from home to the SICU with severe acute abdominal pain in the left

lower quadrant. An abdominal CT reveals free air in the peritoneal cavity and evidence of distal ischemic

colitis. D.L. is taken urgently to the operating room, where she is noted to have gross contamination from

distal colonic perforation with marked peritonitis. After a partial colectomy and abdominal washout, she is

admitted to the SICU for continued resuscitation for septic shock. Which empiric antibiotic regimen would

be most appropriate for D.L.?

Questions 10 and 11 pertain to the following case.

K.D. is a 58-year-old man with severe peripheral vascular disease admitted from home to the SICU with severe

acute abdominal pain in the left lower quadrant. An emergency abdominal CT reveals free air in the peritoneal

cavity and evidence of distal small bowel ischemia. K.D. is taken emergently to the operating room for an

exploratory laparotomy, where he is noted to have gross peritoneal contamination with marked peritonitis from

a small bowel perforation. Intraoperative cultures were sent and are pending. After primary repair of the distal

small bowel and abdominal washout, K.D. returns to the SICU for continued resuscitation for septic shock.

about duration of antimicrobial therapy, which antimicrobial duration limit after source control would be

best to recommend to the team?

Acute pancreatitis is responsible for more than 200,000 acute care admissions annually in the United

States.