Hypotension with scrotal and penile ecchymoses

Published: 12 October 2016
Author(s): Zhe Li, Andrew Smaggus
Issue: October 2016
Section: Internal Medicine Flashcard

A 61-year-old man with a history of end stage renal disease (requiring intermittent hemodialysis) presented to the hospital with hypotension, tachycardia and decreased level of consciousness. A presumptive diagnosis of sepsis was made, and the patient was treated with aggressive intravenous fluid repletion and intravenous piperacillin-tazobactam. He required vasopressor therapy to maintain his blood pressure, and was admitted to the intensive care unit. In the hospital, cultures of blood and urine were negative.