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Clinical Image: From arterial blood gas to bedside diagnosis

From arterial blood gas to bedside diagnosis

[headline_subtitle subtitle=”Can you come up with the proper diagnosis?”]
Presentation
A 37-year old man, with a medical history of obesity, insulin-dependent type 2 diabetes mellitus and asthma was admitted to the emergency room. For the last couple of days, he had been sick with fever, nausea, vomiting, weakness, and shortness of breath. He did not use any alcohol or party drugs. Today, when his girlfriend returned home, she met him in a confused state and called an ambulance. At the emergency room, physical examination shows decreased consciousness, a temperature of 38.4 degrees Celsius, blood pressure of 141/78 mmHg, heart rate of 116/min, and a respiratory rate of 31/min with SpO2 of 94%. Auscultation of heart and lungs revealed no abnormalities. The arterial blood gas is presented below (TABLE 1). Furthermore, X-ray revealed no infiltrate.

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