A 32-year-old male presented to the emergency department (ED) with a productive cough for 4 days and confusion for 2 days prior to presentation. He was febrile, tachycardic, and hypotensive. Initially, labs and influenza A/B PCR were performed. An elevated WBC of 17.3 and a lactate level of 3.1 were noted. He was given a bolus of normal saline and broad spectrum antibiotics, ceftriaxone and azithromycin. The patient was then subsequently found to be positive for influenza A via rapid antigen testing of the nares. On hospital day 2, the patient’s mental status and respiratory distress worsened requiring intubation with mechanical ventilation. CT of the head without contrast revealed symmetric areas of hypoattenuation in the frontoparietal deep white matter. Lumbar puncture showed a slight elevation in WBCs and mild lymphocytic pleocytosis. Brain MRI without contrast revealed symmetric hyperintense T2 FLAIR signaling in the periventricular white matter and the splenium of the corpus callosum. He was found to have encephalitis secondary to influenza A and was started on a course of oseltamivir at higher doses of 150 mg BID for 2 weeks. On hospital day 10, after nine days of intubation, the patient received a tracheostomy due to failure to extubate and no improvement in mental status. He remained ventilator-dependent with little improvement in mental status; the patient was transferred to a long-term acute care hospital (LTACH) facility for further specialized care. He did not show any neurologic recovery or improvement in the three months after initial presentation of symptoms. In the fifth month after the initial symptoms, there was no recovery of preinsult neurologic function. The family had a palliative care meeting to discuss the plan and goals of care. It was decided by close family members that “compassionate extubation” would be done due to ongoing stress on the patient’s body physically and neurologically. This case illustrates the importance of prompt identification and treatment of influenza in the prevention of rapidly progressive sequelae.

abdominal ultrasound showed a hyperechoic focus in the right hepatic lobe corresponding to the findings on CT (Figure 1B). Ultimately, the patient was treated with two weeks of cefepime and metronidazole for her C. perfringens bacteremia with hepatic focus. Her clinical course improved with antimicrobial therapy. Hepatic function tests were within normal limits by the time of discharge. Discussion: C. perfringens causes cytotoxic infection due to its alpha toxin, a lecithinase which breaks down cell membranes leading to cell lysis. Thus, our patient's severe acute anemia is explained in part by hemolysis due to clostridial infection. This organism is an uncommon cause of gas-forming liver abscess. A prior review of 119 cases of patients with gas-forming pyogenic liver abscess found only 8 to be infected with clostridia species. Malignancy and immunosuppression are both risk factors for C. perfringens infection and septicemia, both of which are present in our patient and thus made her more susceptible to clostridial infection. The etiology of her infection was potentially a bacterial translocation from the gastrointestinal tract. Mortality rate in patients with sepsis due to C. perfringens has been previously estimated at 70-100%. Thus, prompt recognition of this clinical syndrome is paramount so that early treatment can be initiated. Early appropriate antimicrobial therapy was essential to this patient's good outcome.[3209] Figure 1. A) A CT scan of the abdomen showing a focus of gas in the right hepatic lobe (arrow). B) An ultrasound of the right upper quadrant showing focus of gas in the right hepatic lobe (arrow).

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Resumen Este trabajo parte de un proyecto de investigación dentro del Doctorado de Estudios Feministas en la Ciudad de México y que hasta el día de hoy sigue en proceso. En él propongo replantear la relación entre mujeres y tecnología computacional en tiempos del capitalismo de datos, atravesado por la postura política que supone el feminismo, tomando en consideración: 1) la problematización en torno al dominio de la técnica en las mujeres; 2) los obstáculos para un conocimiento profundo de la tecnología computacional en tanto cierre de código de programación; y 3) la posibilidad de una autonomía tecnológica en el movimiento feminista del siglo XXI a partir del conocimiento situado y la experiencia. Todo ello echando mano de los principios de la cultura hacker y el movimiento del software libre, y quizá con ello, esbozar los ejes de una posible nueva lucha hackfeminista.