Hypolipidemia contributing to the severity of sepsis triggered by influenza a virus: A case report.

Hypolipidemia, an increasingly diagnosed disorder, is defined as a low-density lipoprotein serum level of <50 mg/dL. Hypolipidemia can be asymptomatic. However, the effect of hypolipidemia on sepsis survival and severity is still to be identified. Multiple studies show the physiologic effects of cholesterol on the immune system, and other studies linked hypolipidemia to increased mortality and morbidity. In this case, we present a young patient admitted for severe sepsis, and he developed multiorgan failure. Workup revealed hypolipidemia. The patient recovered from sepsis with residual renal and cardiac injury. We hypothesized that hypolipidemia could be contributing to the increased morbidity in the patient, although further studies are needed to approve this hypothesis. What is unique about this case is that it sheds light on a commonly overlooked metabolic abnormality that plays a role in the body's response to infections and sepsis. RELEVANCE FOR PATIENTS: This case report presents a previously healthy young patient admitted for pneumonia who had a complicated course. Workup revealed hypolipidemia that can be contributing to the severity of his disease. This observation may lead to more studies to evaluate the relationship between lipoprotein level and disease severity which may change the management for patients with hypolipidemia, especially with the familial type.

Campylobacter jejuni and Pseudomonas coinfection in the setting of ulcerative colitis.

A 66-year-old woman presented with 2 days of fever and severe diarrhoea. She has a history of ulcerative colitis (UC), well controlled with medication. She also has a history of Ehlers-Danlos syndrome, infective endocarditis following aortic valve replacement and pulmonary embolism. She had complained of passing stool with traces of blood about 30 times per day. Stool testing for Clostridium difficile, routine culture and microscopy was done. She was started on ceftriaxone. CT scan revealed thick-walled colon consistent with UC flare. Flexible sigmoidoscopy showed active continuous colitis extending from the rectum to the proximal descending colon. Campylobacter jejuni was isolated from the stool and blood cultures yielded Pseudomonas aeruginosa. The antibiotic was transitioned to intravenous piperacillin/tazobactam and azithromycin followed by 2 weeks of intravenous cefepime. Her diarrhoea was controlled, and she was discharged for follow-up in 2 months.