Okay, welcome. My name is Devine. Welcome to episode 451 of the Devine

Intervention Podcast. In to this podcast we're going to be discussing a topic, but before I discuss that topic, I need to give a vignette first.

What if they give you a question about a 25 year old male.

They tell you that he has a history of multiple mental problems,

mental health problems, and you know he has a history of depression and anxiety and he is

currently on pharmacotherapy although he has not seen his primary care physician in a few months.

And then you're told that he comes into the emergency room because for the past few days he has been having

fevers he has been having chest pain he has been feeling short of breath, he has had like some mild weight loss.

And then they tell you that they are track marks on his skin and they tell you that a new member is heard at the left

upper external border. And sorry, at the left lower external border, I think you're told that blood

cultures are obtained and the patient is started on Empiric Antibiotic Therapy.

Now, they didn't tell you that, you know, results of blood cultures show that,

show gram positive coxi that do not respond to vancomysine therapy that are not

susceptible to vancomysine so that the patient is switched to another therapy.

And then you're told that all 24 hours later,

this patient starts becoming more and more febral. So you know they say maybe

when you came into the hospital is temperature of 102 Fahrenheit, but now it's 104 degrees

Fahrenheit 105. They tell you that he has like some

muscle rigidity and they tell you that he has like 4 plus deep tendon reflexes and they tell you that a urine bag has become red.

And they tell you that he has these hyper kinetic movements of his extremities.

And then our friends at the USMLis will then ask,

what is the next best step in in management and they can put Dantral in as an answer

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