Abstract
When a patient's symptoms apparently progressed with treatment, it was necessary to determine whether her original problem had been supplanted by a new one. Three weeks after undergoing coronary artery bypass grafting, a 60-year-old woman from Bangladesh was admitted to the hospital with chest pain. She was noted to have left upper extremity warmth, erythema, and swelling. Vancomycin was ordered, but the erythema and warmth failed to improve after 4 days of therapy. As a result, a combination of piperacillin and tazobactam was added to the vancomycin.
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