Our problem list included:

#1 Septic shock, probably due to community-acquired pneumonia, but in a potentially immunocompromised patient with SLE on corticosteroids and s/p splenectomy. Septic shock is manifested by hypotension, hypothermia, leukocytosis, and lactic acidosis.

#2 Hypoxemic acute respiratory failure secondary to PNA and septic shock.

#3 Acute kidney injury, which may be due to pre-renal azotemia, but may have other etiologies.

#4 SLE, recently well-controlled on corticosteroids and azathioprine.

#5 H/o ITP, s/p splenectomy. Current platelet count 102K.

#6 H/o hypothyroidism, autoimmune, on T4

#7 H/o antiphospholipid syndrome, manifestations and diagnosis not known.

#8 Allergy to amoxacillin