The results of the patient’s laboratory tests were as follows: WBC count, 28,000 cells/μL, with 77% neutrophils and 8% bands; hematocrit, 29.1%; hemoglobin level, 8.5 g/dL; sodium level, 145 mEq/L; potassium level, 5.4 mEq/L; bicarbonate level, 7.0 mEq/L; chloride level, 101 mEq/L; anion gap, 37; BUN, 48 mg/dL; creatinine level, 8.1 mg/dL; glucose level, 100 mg/dL; calcium level, 7.5 mg/dL; phosphorus, 9.2 mg/dL; total protein level, 6.4 g/dL; albumin level, 3.4 g/dL; lipase level, 189 IU/L; serum osmolality, 329 mOsm/kg; acetone, positive 1:8. The results of his urine chemistry tests were as follows: creatinine level, 160 mg/dL; sodium level, 16 mEq/L; chloride level, 18 mEq/L; potassium level, 16.2 mEq/L; and urea level, 299 mg/dL. Arterial blood gas measurements were as follows: pH, 6.92; Pco2, 18.0 mm Hg; and Po2, 85.7 mm Hg. A chest radiograph revealed basilar and perihilar infiltrates. ECG had tall, peaked T waves in the anterior leads. A CT scan of the brain was negative for acute events. Blood was drawn for cultures, and the results were pending.