22nd May 2024

A 74-year-old male is referred to the acute medical

A 74-year-old male is referred to the acute medical unit by his GP with lethargy and fever. He had felt lethargic for 3-4 days and complained of some left shoulder pain and back pain. He had rigors, but nil else in terms of positive symptomatology. He weighs 83 kg, has a history of Type 2 diabetes, benign prostatic hypertrophy. He is normally on Aspirin 75mg OD, Metformin 1g BD and Gliclazide 80mg BD. He has been in the department for 3 hours and has had IV antibiotics and IV fluids. His Blood pressure is 95/66 mmHg now. It was 88/60 mmHg on a reading an hour ago and 92/60 mmHg on admission 3 hours ago. His GCS is 15, as it was on admission. His RR is 24 and his saturations are 95% on air. His lactate is 2.3 on a VBG, having been 2.5 on admission.

Which of the above factors is a current cause for concern in this patient?

Select the SINGLE most appropriate option from the list below. Select ONE option only.