{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T23:37:21Z","timestamp":1726184241902},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"11-12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>A patient presented to the emergency department with undifferentiated shock 4 days after discharge from a hospitalization for a lower gastrointestinal bleed. The patient fulfilled 4\/4 of the Systemic Inflammatory Response Syndrome criteria and 3\/3 of the quick Sequential Organ Failure Assessment criteria on presentation to the emergency department, notably, without a localized source of infection and no localizing symptoms. After admission, the patient\u2019s hemoglobin was found to have dropped more than expected after intravenous (IV) fluid administration, suggesting a potential alternative or concurrent etiology of the patient\u2019s shock state. A digital rectal and focused assessment with sonography in trauma exam were performed and negative. The patient was then diagnosed with a ruptured infrarenal abdominal aortic aneurysm contained in the retroperitoneum by repeat point-of-care ultrasound. The patient was hemodynamically stabilized and taken for emergent grafting without confirmatory imaging. The patient was later found to also have 4\/4 blood cultures positive with methicillin-sensitive Staphylococcus aureus associated with an aortic valvular vegetation and a mycotic aneurysm which contributed to the abdominal aortic aneurysm rupture. This case supports the use of comprehensive point-of-care ultrasound imaging to more rapidly and more definitively differentiate types of shock and etiologies of a shock state which can lead to more timely changes in management and improvement in outcomes.<\/jats:p>","DOI":"10.1093\/milmed\/usaa205","type":"journal-article","created":{"date-parts":[[2020,8,21]],"date-time":"2020-08-21T11:36:11Z","timestamp":1598009771000},"page":"e2189-e2191","source":"Crossref","is-referenced-by-count":1,"title":["Ruptured Abdominal Aortic Aneurysm Presenting as Septic Shock"],"prefix":"10.1093","volume":"185","author":[{"given":"Bryon","family":"Davis","sequence":"first","affiliation":[{"name":"William Beaumont Army Medical Center, 5005 N. Piedras, El Paso, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron","family":"Brockshus","sequence":"additional","affiliation":[{"name":"William Beaumont Army Medical Center, 5005 N. Piedras, El Paso, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clay","family":"Merritt","sequence":"additional","affiliation":[{"name":"William Beaumont Army Medical Center, 5005 N. Piedras, El Paso, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chase","family":"Donaldson","sequence":"additional","affiliation":[{"name":"William Beaumont Army Medical Center, 5005 N. Piedras, El Paso, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,12,30]]},"reference":[{"issue":"5","key":"2020123002502975600_ref1","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1016\/j.jvs.2008.02.057","article-title":"Meta analysis on mortality of ruptured abdominal aortic aneurysms","volume":"47","author":"Hoornweg","year":"2008","journal-title":"J Vasc Surg"},{"issue":"2","key":"2020123002502975600_ref2","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.jemermed.2004.07.013","article-title":"Ultrasonographic measurement of aortic diameter by emergency physicians approximates results obtained by computed tomography","volume":"28","author":"Knaut","year":"2005","journal-title":"J Emerg Med"},{"key":"2020123002502975600_ref3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2012\/503254","article-title":"Bedside ultrasound in resuscitation and the rapid ultrasound in shock protocol","volume":"2012","author":"Seif","year":"2012","journal-title":"Crit Care Res Prac"},{"issue":"4","key":"2020123002502975600_ref4","first-page":"371","article-title":"Infected abdominal aortic aneurysm: in situ replacement with cryopreserved arterial homograft","volume":"38","author":"Alonso","year":"1997","journal-title":"J Cardiovasc Surg (Torino)"},{"issue":"2","key":"2020123002502975600_ref5","first-page":"209","article-title":"Mycotic aneurysm rupture: report of four cases","volume":"91","author":"Huang","year":"1992","journal-title":"J Formos Med Assoc"},{"issue":"3","key":"2020123002502975600_ref6","doi-asserted-by":"crossref","DOI":"10.1093\/jscr\/rjw040","article-title":"Aortitis causing rapid growth of a mycotic aortic aneurysm","volume":"2016","author":"Williams","year":"2016","journal-title":"J Surg Case Rep"},{"issue":"5","key":"2020123002502975600_ref7","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/S0016-5107(86)71880-4","article-title":"Bacteremia with gastrointestinal endoscopic procedures","volume":"32","author":"Botoman","year":"1986","journal-title":"Gastrointest Endosc"},{"issue":"4","key":"2020123002502975600_ref8","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1007\/s12328-013-0401-2","article-title":"Primary aortoenteric fistula","volume":"6","author":"Vilas-Boas","year":"2013","journal-title":"Clin J Gastroenterol"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/milmed\/article-pdf\/185\/11-12\/e2189\/35269057\/usaa205.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/milmed\/article-pdf\/185\/11-12\/e2189\/35269057\/usaa205.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,30]],"date-time":"2020-12-30T07:53:29Z","timestamp":1609314809000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/185\/11-12\/e2189\/5894992"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,1]]},"references-count":8,"journal-issue":{"issue":"11-12","published-online":{"date-parts":[[2020,12,30]]},"published-print":{"date-parts":[[2020,12,30]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usaa205","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,11,1]]},"published":{"date-parts":[[2020,11,1]]}}}