"Address the patient’s chief complaint first. In this case, the other symptoms were only side effects of the main problem.

Pay attention to lab work. In this case, the elevated white blood count and the related blood culture results.

Keep an open mind, broaden your differential and document your medical decision-making (MDM), especially when sending a patient home with pending blood cultures.

Avoid anchoring bias and premature closure based on a patient’s self-diagnosis. This teen’s report of a lifting injury does not comport with his signs and symptoms.

Follow your hospital’s procedures on abnormal lab results.

Don’t automatically write off 'preliminary' culture results."

Charles A. Pilcher is an emergency physician and editor, Medical Malpractice Insights - Learning from Lawsuits.

He shares his story and discusses his KevinMD article, "Teen dies when blood culture protocol botched: What can we learn from this tragedy?"

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