3rd August 2023

A 43-year-old man is admitted from ED to the Intensive Care Unit with a history of jaundice, high-grade fever

A 43-year-old man is admitted from ED to the Intensive Care Unit with a history of jaundice, high-grade fever, frank haemoptysis, and haemodynamic instability. The family state he returned from ‘field’ working in South India 8 days ago as an Engineer Consultant for local flood infrastructure. The region was experiencing the early days of the monsoon season before he left. He told them he had taken all his vaccines and malaria prophylaxis.

Observations: BP 74/43 mmHg, sinus HR 122 bpm, 72% oxygen saturations prior to intubation and ventilation.

Blood tests: Hb 82, WCC 19.3, Platelets 190, CRP 363, Bilirubin 53, K⁺ 6.3, Na⁺ 129, Creatinine 152, Urea 9.2, INR 1.1.

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