What Do These Clinical Findings Indicate A 71-year-old woman is admitted to the intensive care unit from a nursing home because of flank pain, confusion, and fever. Physical examination: Body temperature: 38.5°C (101 .3°F). Blood pressure: 82/48 mm of Hg. Heart rate: 123 beats/minute. Respiration rate: 30 breaths/minute. Dry mucous membranes and costovertebral angle tenderness.
Poor skin turgor, and an absence of edema. Medical examination: Leukocyte count: 15,600/uL. Urinalysis shows 50 to 100 leukocytes and many bacteria per high power field. The patient has an anion-gap metabolic acidosis and high lactic acid level. Antibiotic therapy is started.
