Bacteroides bundle of joy: sepsis from a degenerating/necrotic fibroid

In the emergency room, she was tachycardic, tachypnic and febrile to 40.5°C. Significant laboratory findings included an elevated procalcitonin at 4.63 ng/mL, thrombocytopenia and lactic acidosis. A thorough history, physical examination, further laboratory evaluation and review of imaging revealed no evidence for acute cystitis, pyelonephritis, appendicitis, cholangitis, pancreatitis, pneumonia, cellulitis, meningitis or encephalitis. On hospital day 2, blood cultures were positive; Gram stain showed Gram-negative rods.