His temperature was
98.8°F; blood pressure, 118/57 mm Hg (sitting); heart rate,
62 beats/minute; and respiratory rate, 18 breaths/minute. Physical
exam revealed a 3 cm abrasion on the right forearm with
mild erythema, minimal warmth, and no swelling or exudate
and a nontender ulcerated lesion on the right second toe with no
exudate. His white blood cell count was 12.5 K/µl. He received a
1 L 0.9% saline bolus, and blood cultures were collected. Lactate
results were initially 3.0 mmol/L and decreased to 2.0 mmol/L
when redrawn following the fl uid bolus. He was discharged
with directions to follow up with his primary care physician.