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rapidly developing septic shock

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https://www.readbyqxmd.com/read/29570107/extensive-myocardial-calcification-in-critically-ill-patients
#1
Natacha Kapandji, Alban Redheuil, Pierre Fouret, Guillaume Hékimian, Guillaume Lebreton, Nicolas Bréchot, Charles-Edouard Luyt, Philippe Cluzel, Alain Combes, Matthieu Schmidt
OBJECTIVES: To describe an unusual complication on extracorporeal membrane oxygenation. DATA SOURCES: Clinical observation. STUDY SELECTION: Case report. DATA EXTRACTION: Relevant clinical information. DATA SYNTHESIS: We report the cases of three young patients who developed extensive myocardial calcifications on prolonged extracorporeal membrane oxygenation support for severe acute respiratory distress syndrome with septic cardiomyopathy, postresuscitation cardiogenic shock, and septic shock complicating severe acute respiratory distress syndrome, respectively...
March 21, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29526382/neonatal-nonpolio-enterovirus-and-parechovirus-infections
#2
REVIEW
Nada Harik, Roberta L DeBiasi
Nonpolio enteroviruses and parechoviruses are frequent causes of neonatal infection. Clinical manifestations of infection range from asymptomatic infection to mild infection without sequelae to septic shock with muiltiorgan failure. Neonates with clinically apparent infection typically have mothers and/or other contacts with recent symptoms consistent with a viral illness. Severe neonatal infection with nonpolio enterovirus or parechovirus cannot be differentiated clinically from serious bacterial infection...
March 8, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29487661/tension-pneumocephalus-mimicking-septic-shock-a-case-report
#3
Caroline Miranda, Ali Mahta, Lee Adam Wheeler, A John Tsiouris, Hooman Kamel
Tension pneumocephalus can lead to rapid neurologic deterioration. We report for the first time its association with aseptic systemic inflammatory response syndrome mimicking septic shock and the efficacy of prompt neurosurgical intervention and critical care support in treating this condition. A 64-year-old man underwent 2-stage olfactory groove meningioma resection. The patient developed altered mental status and gait instability on postoperative day 6. Imaging showed significant pneumocephalus. The patient subsequently developed worsening mental status, respiratory failure, and profound shock requiring multiple vasopressors...
February 2018: Radiology Case Reports
https://www.readbyqxmd.com/read/29390437/chronic-primary-adrenal-insufficiency-after-unilateral-adrenonephrectomy-a-case-report
#4
Satoshi Yoshiji, Kimitaka Shibue, Toshihito Fujii, Takeshi Usui, Keisho Hirota, Daisuke Taura, Mayumi Inoue, Masakatsu Sone, Akihiro Yasoda, Nobuya Inagaki
RATIONALE: Unilateral adrenalectomy as part of surgical resection of renal cell carcinoma (RCC) is not thought to increase the risk of chronic adrenal insufficiency, as the contralateral adrenal gland is assumed to be capable of compensating for the lost function of the resected gland. However, recent studies have indicated that adrenalectomy might cause irreversible impairment of the adrenocortical reserve. We describe a case of chronic primary adrenal insufficiency in a 68-year-old man who previously underwent unilateral adrenonephrectomy, which was complicated by severe postoperative adrenal stress that involved cardiopulmonary disturbance and systemic infection...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29384877/acute-appendicitis-complicated-with-necrotizing-fasciitis-in-a-patient-with-adult-onset-still-s-disease-a-case-report
#5
Zheng-Hao Huang, Yu-Chen Chiu, Li-Lu Ho, Hsiu-Lung Fan, Chun-Chi Lu
RATIONALE: Adult-onset Still disease (AOSD) is a rare systemic inflammatory disease of unknown etiology characterized by evanescent salmon-pink rash, spiking fever, arthralgia/ arthritis, and lymphadenopathy. AOSD sometimes was fatal when it is complicated by macrophage activation syndrome (MAS) or hemophagocytic lymphohistiocytosis (HLH). Nonetheless, the literature provides no recommendations for treatment of AOSD patients with severe sepsis. PATIENT CONCERNS: A previously healthy 65-year-old man with history of AOSD was referred to our hospital for persistent right lower quadrant abdominal pain for 2 days...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29335396/barogenic-rupture-of-esophagus-boerhaave-syndrome-as-diagnostic-and-therapeutic-challenge-requiring-rapid-and-effective-interdisciplinary-cooperation-case-report
#6
Piotr Czopnik, Michał Aporowicz, Agnieszka Niepokój-Czopnik, Tobiasz Szajerka, Paweł Domosławski
We describe a 47-year-old male who was admitted to our centre from a local emergency unit with septic shock due to suspected Boerhaave syndrome. After the diagnosis was confirmed, the patient underwent emergency surgery. Postoperatively, the patient had symptoms of acute alcoholic delirium, and developed an oesophagomediastinal fistula as the most serious local complication. Successful conservative treatment enabled complete healing of the fistula, leading to patient recovery. No late complications like oesophageal stenosis were found at 6 months from discharge...
December 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29306854/successful-management-of-a-24-year-old-pregnant-woman-with-necrotising-fasciitis-of-the-forearm
#7
Sam Nahas, Anne McKirdy, Arjuna Imbuldeniya
A 24-year-old woman who was 24 weeks pregnant presented to the emergency department with septic shock and an elbow wound that had become infected. She sustained an injury to the tip of the right elbow on a light switch 4 days prior. In the space of 1 day, she developed a necrotising soft tissue infection, which was rapidly spread to the forearm with florid sepsis. Her initial serum C reactive protein was 392 mg/L, and white cell count was 32×109 /L. The patient was treated promptly with aggressive surgical debridement and broad-spectrum antibiotics...
January 6, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29251709/benchmarking-clinical-outcomes-and-the-immunocatabolic-phenotype-of-chronic-critical-illness-after-sepsis-in-surgical-intensive-care-unit-patients
#8
Julie A Stortz, Juan C Mira, Steven L Raymond, Tyler J Loftus, Tezcan Ozrazgat-Baslanti, Zhongkai Wang, Gabriela L Ghita, Christiaan Leeuwenburgh, Mark S Segal, Azra Bihorac, Babette A Brumback, Alicia M Mohr, Philip A Efron, Lyle L Moldawer, Frederick A Moore, Scott C Brakenridge
BACKGROUND: A growing number of patients survive sepsis but remain chronically critically ill. We sought to define clinical outcomes and incidence of chronic critical illness (CCI) after sepsis and to determine whether selected biomarkers of inflammation, immunosuppression, and catabolism differ between these patients and those that rapidly recover (RAP). METHODS: This 3-year prospective observational cohort study (NCT02276417) evaluated 145 surgical intensive care unit patients with sepsis for the development of CCI (≥14 days of intensive care unit resource utilization with persistent organ dysfunction)...
February 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29181204/a-case-of-invasive-pneumococcal-infection-with-septic-shock-and-rare-complications
#9
John R Woytanowski, Nausheen Hakim, Caytlin Deering, Sara Schultz
Invasive pneumococcus is a serious illness with potentially devastating outcomes. A 64-year-old female with a medical history of psoriatic arthritis and diabetes was transferred from an outside hospital for ventilator dependent respiratory failure and altered mental status. She initially presented with worsening back pain and was found to have leukocytosis with bandemia and acute renal failure but she was in septic shock upon arrival to our tertiary care center. Her blood cultures grew Streptococcus pneumoniae and MRI of the brain revealed pus within the posterior lateral ventricles and multiple infarcts...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29122896/persistent-bacteraemia-caused-by-staphylococcus-aureus-in-the-gall-bladder
#10
Alexander Tin Han Yu, Tony Cun, Esther Benamu, Cybele Renault
Staphylococcus aureusbacteraemia (SAB) remains a complex disease with a high associated morbidity and mortality, especially when it is able to establish an occult nidus safe from antimicrobial eradication. Without rapid identification and intervention, the nidus can cause persistent relapse of disease, morbidity and mortality. Having a high clinical suspicion for the foci of occult S. aureus is important, and awareness of potential sites of infection is critical and can be life-saving.We present a unique case of a 65-year-old man with end-stage renal disease receiving haemodialysis who developed septic shock from SAB...
November 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29109870/acute-onset-panhypopituitarism-nearly-missed-by-initial-cosyntropin-testing
#11
Claudine A Blum, Daniel Schneeberger, Matthias Lang, Janko Rakic, Marc Philippe Michot, Beat Müller
Introduction: Diagnosis of adrenal crisis and panhypopituitarism in patients with septic shock is difficult but crucial for outcome. Case: A 66-year-old woman with metastasized breast cancer presented to the ED with respiratory insufficiency and septic shock after a 2-day history of the flu. After transfer to the ICU, corticosteroids were started in addition to antibiotics, as the patient was vasopressor-nonresponsive. Diabetes insipidus was diagnosed due to polyuria and treated with 4 mg desmopressin...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29033819/an-unusual-presentation-of-pyoderma-gangrenosum-leading-to-systemic-inflammatory-response-syndrome
#12
Ali Didan, Alan Donnelly, Hock Chua
This is a report of an atypical presentation of pyoderma gangrenosum (PG) in a 26-year-old male who had a negative septic screen. The patient had a life-threatening presentation requiring an intensive care unit (ICU) admission for vasopressor support. It was thought that the likely cause of circulatory collapse was an overwhelming cytokine reaction or systemic inflammatory response syndrome (SIRS) secondary to extensive PG lesions rather than septic shock. The patient presented with multiple large ulcers, the largest being 4 cm in diameter on the central chest...
September 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/29023361/procalcitonin-and-mr-proadrenomedullin-combination-with-sofa-and-qsofa-scores-for-sepsis-diagnosis-and-prognosis-a-diagnostic-algorithm
#13
Silvia Spoto, Eleonora Cella, Marina de Cesaris, Luciana Locorriere, Silvia Mazzaroppi, Edoardo Nobile, Arcangela M Lanotte, Lucia Pedicino, Marta Fogolari, Sebastiano Costantino, Giordano Dicuonzo, Massimo Ciccozzi, Silvia Angeletti
PURPOSE: The third Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) defined sepsis as an organ dysfunction consequent to infection. A SOFA score ≥2 identifies sepsis. In this study, PCT and MR-proADM were evaluated along with SOFA and qSOFA scores in patients with sepsis or septic shock. METHODS: One hundred and nine septic patients and 50 patients with non-infectious disease admitted at the Department of Internal Medicine and General Surgery of the University Hospital Campus Bio-Medico of Rome were enrolled...
October 11, 2017: Shock
https://www.readbyqxmd.com/read/28993363/rare-postoperative-complication-clostridium-perfringens-septic-shock-following-elective-abdominal-surgery
#14
Michael Bath, Mark McKelvie, Khalid Canna
Postoperative infections are one of the most common complications in general surgery, and while rates have reduced with the routine administration of perioperative antibiotics, around 5% of patients undergoing a surgical procedure will develop an infective complication.(1) The Gram-positive, obligate anaerobe, Clostridium perfringens, is a well-known pathogen that forms part of both the environmental and gastrointestinal flora.(2) While more commonly associated with food poisoning, anaerobic cellulitis and traumatic gas gangrene, rare cases of spontaneous non-traumatic gas gangrene of abdominal viscera have also been recorded...
October 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28969197/neglected-necrotizing-fasciitis-a-rare-complication-of-spinal-anaesthesia
#15
Karikal Chakaravarthi, Ashish Gupta, Lileswar Kaman
Necrotizing Fasciitis (NF) is a rare, rapidly progressive severe bacterial soft tissue infection with a high mortality rate. NF classically involves the trunk, groin/perineum, lower limbs, and postoperative wound sites. NF secondary to spinal anaesthesia in a young postpartum female is extremely rare. Here we are describing a young postpartum female who underwent cesarean section for the delivery of child but developed NF of the back starting from the site of spinal needle insertion. She was referred to our center after 21 days of surgery with extensive NF...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28915308/mutilating-purpura-fulminans-in-an-adult-with-meningococcal-sepsis
#16
María Elena Arnáiz-García, Ana María Arnáiz-García, Francisco Gutierrez-Diez, Juan Francisco Nistal, Jose María González-Santos, Ivana Pulitani, Carlos Amado-Diago, Javier Arnáiz
We report a dramatic case of meningococcal sepsis manifesting as purpura fulminans in an elderly diabetic woman. Hemodynamic instability and severe bilateral cutaneous lesions involving her hands and feet developed rapidly. Specific antibiotic therapy and the administration of inotropic and vasopressor drugs were initiated. The severity and extension of the cutaneous lesions (attributed to purpura fulminans) worsened because of the need for vasoconstrictors for the treatment of septic shock. Bilateral transmetatarsal and metacarpal amputations were required to stabilize the patient...
September 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/28894449/type-i-interferon-induced-by-streptococcus-suis-serotype-2-is-strain-dependent-and-may-be-beneficial-for-host-survival
#17
Jean-Philippe Auger, Agustina Santinón, David Roy, Karen Mossman, Jianguo Xu, Mariela Segura, Marcelo Gottschalk
Streptococcus suis serotype 2 is an important porcine bacterial pathogen and emerging zoonotic agent mainly responsible for sudden death, septic shock, and meningitis, with exacerbated inflammation being a hallmark of the infection. However, serotype 2 strains are genotypically and phenotypically heterogeneous, being composed of a multitude of sequence types (STs) whose virulence greatly varies: the virulent ST1 (Eurasia), highly virulent ST7 (responsible for the human outbreaks in China), and intermediate virulent ST25 (North America) are the most important worldwide...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28876654/ileosigmoid-knotting-a-zimbabwean-case-series
#18
C Mbanje, S Mungazi, A J V Maunganidze
BACKGROUND: Ileosigmoid knotting is a rare cause of intestinal obstruction with a rapidly progressive course, for which expedient surgical intervention is required to avoid mortality. METHOD: A combined retrospective and prospective analysis was performed on 16 patients operated on at PGH with an operative diagnosis of ileosigmoid knotting between February 2011 and April 2016. Data inclusive of demographics, time to presentation and surgery, preoperative diagnostic accuracy, incidence of septic shock and mortality was collected...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28859468/clinical-and-microbiological-factors-associated-with-early-patient-mortality-from-methicillin-resistant-staphylococcus-aureus-bacteremia
#19
Tark Kim, Yong Pil Chong, Ki-Ho Park, Kyung Mi Bang, Su-Jin Park, Sung-Han Kim, Jin-Yong Jeong, Sang-Oh Lee, Sang-Ho Choi, Jun Hee Woo, Yang Soo Kim
Background/Aims: Methicillin-resistant Staphylococcus aureus bacteremia (MRSAB) is a major bloodstream infection with a high mortality rate. Identification of factors associated with early mortality in MRSAB patients would be useful for predicting prognosis and developing new therapeutic options. Methods: A prospective cohort of MRSAB patients was examined between August 2008 and June 2011. Early and late mortality was defined as death within 2 and 28 days of blood culture, respectively...
July 6, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28858918/implementation-of-the-surviving-sepsis-campaign-guidelines
#20
Vikramjit Mukherjee, Laura Evans
PURPOSE OF REVIEW: Early identification and appropriate management of sepsis improves outcomes. Despite convincing data showing the benefits of early recognition and treatment of sepsis and septic shock, implementation of such evidence-based therapy is suboptimal. This review describes methods that have been shown to improve bedside application of the evidence-based guidelines. RECENT FINDINGS: The Surviving Sepsis Campaign (SSC) has developed guidelines for the management of severe sepsis and septic shock...
October 2017: Current Opinion in Critical Care
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