I was asked to admit a patient with a diagnosis of heart failure. However, upon further review of the history, I found that the story did not match the one about heart failure, and I had to take a step back and add more testing to figure out what was going on. It turned out the patient was in florid sepsis, with an unclear cause. The patient was boarding in the ED, and Nurse Laura paged me, expressing concern over the patient’s skin condition after helping him get cleaned up after using the bathroom.

The patient did not complain about anything in his gluteal area (where the concern was), and I frankly would not have thought to examine him there. But, after being notified by her and examining the patient, I was very concerned about its appearance, so I added stat CT studies. The patient ultimately had Fournier’s gangrene/necrotizing fasciitis and went to the OR emergently that night.

Laura’s recognition of something abnormal and prompt notification likely saved this patient’s life. Certainly, any delay in care in this clinical situation can have serious consequences. We have a great team here at Parker, and the pathology we experience here never ceases to surprise me.