MDM //

s/p renal transplant_ and s/p OHT_ who presents with fever for past several days and intermittent productive cough_. Despite patient being well appearing, will perform septic workup with concern for possible CAP. Will obtain CXR, labs, blood cultures, urine cultures, UA. Will also get troponin (to evaluate for myocarditis), BNP (to trend for possible rejection). No overt evidence of fluid overload at this time. No overt hospital acquired risk factors but given immunosuppression and concern for pulmonary cause, will empirically treat with vanc/cefepime/azithromycin_ and will defer to medicine team to narrow. Although grafts working well on prior visit, as patient not overtly septic, will gently hydrate with NS given hemodynamic stability and propensity for possible graft dysfunction/fluid overload_.



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