Treat the Patient as a Whole, Not Just the Laboratory Findings: A Case of Contaminated Blood Cultures With Subsequent Iatrogenic Complications.

Sepsis is a serious condition involving life-threatening infection-driven immune response and organ dysfunction. In the emergency department (ED), patients at high risk for sepsis or those with suspected sepsis are managed with a standardized protocol which includes empiric broad-spectrum antibiotic therapy pending blood culture results and susceptibilities, if applicable. While the benefits generally outweigh the risks, this approach may lead to complications, including allergic reactions, gastrointestinal irritation, acute kidney injury, and even financial toxicity, particularly in cases of contaminated blood cultures. We describe a case of a 68-year-old woman who presented to the ED with clinical signs of infection, and an initial workup significant for leukocytosis without a clear source of infection. Blood cultures were obtained and the patient was discharged with azithromycin. She was recommended to follow up with her primary care provider. However, the blood cultures grew coagulase-negative, gram-positive cocci and the patient was asked to return to the ED for admission. She was treated with intravenous vancomycin and subsequently developed acute kidney injury (AKI). Further investigation revealed that the blood cultures were contaminated with