Clinical response to unintentionally rapid infusion of drotrecogin alfa (activated).

Purpose: The case of a patient with severe sepsis who received a bolus dose of 184 microg/kg of drotrecogin alfa (activated) over one hour is reported.

Summary: An 84-year-old woman who had undergone right total knee replacement was admitted to the hospital from a rehabilitation facility with an initial diagnosis of mental status changes and a suspected urinary tract infection. Examination of the patient's incision from her recent knee surgery revealed a discharge, and a culture was obtained.

Fondaparinux therapy in a hemodialysis patient with heparin-induced thrombocytopenia type II.

Purpose: The successful use of fondaparinux in a hemodialysis patient with heparin-induced thrombocytopenia type II (HIT II) is reported.

Summary: An 85-year-old, 68-kg Caucasian woman came to the emergency department with shortness of breath and exertional chest pain radiating to the neck. Testing revealed non-ST-segment elevation myocardial infarction, severe coronary artery disease, mitral regurgitation, left ventricular dysfunction, an ejection fraction of 25-30%, and pulmonary arterial hypertension.