Abstract
### Case Description A 62-year-old man with a past medical history of diabetes mellitus presented to the hospital with shortness of breath and nonproductive cough. His vital signs revealed the following: BP, 83/52 mm Hg; heart rate, 119 beats per minute; respiratory rate, 28 breaths/min; oxygen saturation, 60% on room air; temperature, 103.3°F. Cardiopulmonary examination demonstrated sinus tachycardia and bilateral crackles. Initial basic laboratory values were as follows: white blood cells, 13.6 K/mm3 with neutrophil predominance; hemoglobin, 11.8 g/dl; platelets, 264 K/mm3; sodium, 135 mmol/L; potassium, 5.5 mmol/L; chloride, 97 mmol/L; bicarbonate, 21 mmol/L; BUN, 44 mg/dl; serum creatinine, 3.47 mg/dl; calcium, 7.4 mg/dl; albumin, 2.4 g/dl; normal liver function tests; lactate, 2.7 mmol/L; C-reactive protein, >300 mg/dl; D-dimer, 13,900 ng/ml; fibrinogen, 598 mg/dl; ferritin, 392 ng/ml; partial thromboplastin time, 73 seconds. Urinalysis was negative for hematuria or proteinuria. Urine sediment …
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