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Consult: ID for Sepsis of Unknown Origin

Call the ID fellow about a complex patient with persistent fevers despite antibiotics, practicing how to organize and present a multi-day case.

  1. 1
    Briefing
  2. 2
    Simulation
  3. 3
    Feedback

How This Works

This is an interactive phone call simulation. You'll speak with Dr. Wells in a realistic clinical communication scenario.

1. Start Call

Click "Start Call" when you're ready. Speak naturally as you would on a real call.

2. Have the Conversation

10 minutes to complete the call. The AI responds in real-time to what you say.

3. Get Feedback

End the call when finished. You'll receive AI-powered feedback on your communication.

💡 Tip: Speak clearly and at a natural pace. If you need a moment to think, it's okay to pause briefly - just as you would in a real conversation.

Briefing Details

Consult Briefing

Your Objective

You are the hospitalist caring for a patient with persistent fevers and no clear source of infection. You are stuck and need help from a specialist. Your goal is to call the on-call Infectious Disease fellow, Dr. Wells, to discuss the case. This is not a simple consult; it requires you to organize and present a multi-day hospital course and frame a broad, thoughtful question.

Patient: Susan Davis, 68F

  • Room: 920
  • Code Status: Full Code

Case Summary & Data

History: 68F with a history of diabetes was admitted 3 days ago from a nursing home with altered mental status and hypotension, diagnosed with septic shock. An initial workup including chest x-ray and urinalysis was unrevealing.

Hospital Course: She was started on broad-spectrum antibiotics (Vancomycin and Zosyn) on Day 1. Despite this, she continues to have daily fevers up to 102°F (38.9°C).

Workup So Far:

  • Cultures: Blood cultures x3 sets, urine culture, and a sputum culture are all negative at 72 hours.
  • Imaging: A CT of the chest, abdomen, and pelvis performed yesterday showed no abscess or clear source of infection.
  • Lines: She has one peripheral IV. No central lines or foley catheter.

The Clinical Question

You have a patient with persistent fevers despite 72 hours of appropriate broad-spectrum antibiotics and a negative initial workup. You are concerned about a resistant organism, a non-bacterial infection (like fungal), or a non-infectious cause of fever.

Your "Ask": Your question for the ID fellow is: "I have a patient with sepsis of unknown origin who is not responding to therapy. I would appreciate your help in broadening the differential diagnosis and recommending next steps in the workup and antimicrobial management."

Learning Objectives

Optional prep details

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Optional Pre-Call Knowledge Check

Optional self-check before you start

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After completing this scenario, you will be able to:

  • Synthesize a multi-day hospital course into a concise and organized oral presentation for a specialist consultant.
  • Formulate a clear and specific clinical question for a consultant when the diagnosis is uncertain.
  • Apply the SBAR (Situation, Background, Assessment, Recommendation) framework to structure a complex consultation call.

When consulting a specialist about a complex patient with a multi-day course and an unclear diagnosis, what is the most effective way to begin the conversation after initial introductions?

For a hospitalized patient with persistent fevers despite broad-spectrum antibiotics, which of the following is a key consideration to include in your differential diagnosis?

When preparing to present this multi-day case, which data set is MOST critical to synthesize into a clear trend or timeline?