Jean kelly is an 82 year old woman who has been feeling more fatigued for the last three days and has had a fever the last twenty-four hours. she reports painful, burning sensation when she urinates as well as frequency of urination the last week. it has been > 90 degrees this past week. she usually drinks 2-3 glasses of liquid a day and a cup of tea. her daughter became concerned and brought her to the emergency department (ed) when she did not know what day it was. she is mentally alert with no history of confusion.

As enlisted in the symptoms, both fever and fatigue indicate a more serious problem. Having a painful, burning sensation when urinating indicates symptoms of a urinary tract infection (UTI). However, further tests are required to find out the true condition of the patient.

Even with any kind of infection, if the patient qualifies at least to or more of the following criteria of Systemic Inflammatory Response Syndrome (SIRS), it is identified to be sepsis.

·         Temp >100.4 or <96.8

·         HR >90

·         RR >20

·         WBC >12,000 or <4000

·         Bands >10%

With the new episode of confusion, it is considered a red flag for older people. Though it may be a sign of a neurological problem, other symptoms mentioned in the scenario are mostly related to a common infection such as (UTI).  

the correct answer is 2 and 4