PCR for Everything—Seeking Value in Speed: With faster and more comprehensive diagnostic tests becoming widely available, we need to think more carefully about whether they truly improve patient care

In the summer of 2013, a patient arrived in our emergency department with complaints of high fever and abdominal pain. She came to us straight from the airport following her return from a 3-month visit to India. Identified as septic, she was “pan-cultured,” meaning readily obtained fluids and substances were sent immediately to begin cultures. Due to concerns for bacterial gastroenteritis, she received ceftriaxone in the emergency department and ciprofloxacin after admission. Fevers continued and blood cultures yielded Escherichia coli, which was phenotypically resistant to most antibiotics, including ceftriaxone and ciprofloxacin, but susceptible to “last-resort” carbapenems, which were then used to treat her.