scholarly journals Leptospirosis with pulmonary haemorrhage and multiple organ failure: a case report and literature review

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110196
Author(s):  
Wei-Hua Dong ◽  
Zhi Chen
Keyword(s):  
Multiple Organ Failure ◽  
Organ Failure ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Lavage Fluid ◽  
Haemorrhagic Shock ◽  
Multiple Organ ◽  
Pulmonary Haemorrhage ◽  
Life Threatening ◽  
History Of

Pulmonary haemorrhage is an important complication of leptospirosis. We herein report an uncommon case of severe pulmonary haemorrhage and multiple organ failure caused by leptospirosis in a 49-year-old man who was previously healthy. He was a farm worker who was admitted to the hospital because of haemoptysis. He had worked in a paddy field 4 days prior to admission. Chest computed tomography revealed pulmonary haemorrhage, which rapidly deteriorated into haemorrhagic shock and multiple organ failure. Based on the patient’s possible history of contact with contaminated water and the DNA sequence of Leptospira detected in his bronchoalveolar lavage fluid, the patient was diagnosed with pulmonary haemorrhagic leptospirosis. Despite the administration of a fluid bolus, norepinephrine, broad-spectrum antibiotics, and haemostatics, and even with administration of a blood transfusion and extracorporeal life support, the pulmonary haemorrhage could not be controlled effectively. The patient eventually died of haemorrhagic shock. Leptospirosis can be a life-threatening disease despite aggressive treatment, even with extracorporeal life support. Next-generation sequencing can provide important diagnostic clues for patients with atypical leptospirotic symptoms.

Multiple Organ Failure and Refractory Cardiogenic Shock due to Venlafaxine Intoxication, Successfully Treated with Veno-Arterial Extracorporeal Life Support

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Painvin B ◽  
◽  
Le Balc’h P ◽  
Gicquel T ◽  
Camus C ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Multiple Organ ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Prolonged Release ◽  
Refractory Cardiogenic Shock

Venlafaxine has critical side effects from arrhythmias to cardiogenic shock after toxic dose ingestion. We report a case of venlafaxine intoxication with Multiple Organ Failure (MOF) treated with Veno-Arterial Extracorporeal Life Support (VA-ECLS). A 60-year old male with a history of chronic depression ingested 72 tablets of prolonged-release venlafaxine hydrochloride 75 mg (total 5400 mg). Initial EKG showed broadened QRS complexes and Transthoracic Echocardiography (TTE) revealed diffuse ventricular hypokinesia with Left Ventricular Ejection Fraction (LVEF) of 15% for which dobutamine infusion was started. Due to persistent refractory cardiogenic shock and MOF, a Medos® Deltastream® VA-ECLS was surgically implanted in our intensive care unit. On day 1, toxicology analysis found plasma concentrations of venlafaxine 3.2mg/L and its metabolite desmethylvenlafaxine at 0.92 mg/L. At day 6, we performed a weaning trial, enabling ECLS removal. Motion defect of anteroseptal and inferolateral walls was also noticed. EKGs showed a shorten R wave in the anteroseptal territory leading to the potential diagnosis of underlying ischemic cardiomyopathy. The patient was extubated at day-10 and discharged for cardiology unit at day-17. At day-20, cardiac magnetic resonance imaging showed no sign of ischemia and TTE parameters were normalized. This is the first report of refractory cardiogenic shock and MOF due to venlafaxine intoxication treated with VA-ECLS. The main objective of ECLS is to restore cardiac output especially when ventricular failure is refractory to inotropes. Our experience suggests that MOF secondary to refractory cardiogenic shock should quickly prompt the implantation of a VA-ECLS in venlafaxine critical overdose.

scholarly journals Post-COVID-19 Kawasaki-Like Syndrome

2021 ◽  
pp. 014556132110060
Author(s):  
Jérôme R. Lechien ◽  
Rémi Hervochon ◽  
Stéphane Hans
Keyword(s):  
Abdominal Pain ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Hepatitis A ◽  
Clinical Presentation ◽  
Multiple Organ ◽  
Mild Form ◽  
Severe Dysphagia ◽  
History Of ◽  
Inflammatory Syndrome

A 42-year-old man was referred for a week history of severe dysphagia, odynophagia, fever (39 °C), fatigue, abdominal pain, pharyngeal swelling, and multiple neck lymphadenopathies. The medical history reported a mild form of COVID-19 one month ago. The biology reported an unspecified inflammatory syndrome. The patient developed peritonitis, myocarditis, and hepatitis. A myocardium biopsy was performed. A diagnosis of Kawasaki-like disease (KLD) was performed. The occurrence of KLD in adults is rare but has to be known by otolaryngologists regarding the otolaryngological clinical presentation that may precede the multiple organ failure.

Oncologists’ and Intensivists’ Attitudes Toward the Care of Critically Ill Patients with Cancer

2017 ◽  
Vol 34 (10) ◽  
pp. 811-817 ◽  
Author(s):  
Antonio Paulo Nassar ◽  
Aldo Lourenço Abadde Dettino ◽  
Cristina Prata Amendola ◽  
Rodrigo Alves dos Santos ◽  
Daniel Neves Forte ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Pancreatic Cancer ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Life Support ◽  
Multiple Organ ◽  
Patients With Cancer ◽  
Support Measures

Background: Patients with cancer represent an important proportion of intensive care unit (ICU) admissions. Oncologists and intensivists have distinct knowledge backgrounds, and conflicts about the appropriate management of these patients may emerge. Methods: We surveyed oncologists and intensivists at 2 academic cancer centers regarding their management of 2 hypothetical patients with different cancer types (metastatic pancreatic cancer and metastatic breast cancer with positive receptors for estrogen, progesterone, and HER-2) who develop septic shock and multiple organ failure. Results: Sixty intensivists and 46 oncologists responded to the survey. Oncologists and intensivists similarly favored withdrawal of life support measures for the patient with pancreatic cancer (33/46 [72%] vs 48/60 [80%], P = .45). On the other hand, intensivists favored more withdrawal of life support measures for the patient with breast cancer compared to oncologists (32/59 [54%] vs 9/44 [21%], P < .001). In the multinomial logistic regression, the oncology specialists were more likely to advocate for a full-code status for the patient with breast cancer (OR = 5.931; CI 95%, 1.762-19.956; P = .004). Conclusions: Oncologists and intensivists share different views regarding life support measures in critically ill patients with cancer. Oncologists tend to focus on the cancer characteristics, whereas intensivists focus on multiple organ failure when weighing in on the same decisions. Regular meetings between oncologists and intensivists may reduce possible conflicts regarding the critical care of patients with cancer.

Successfully treated necrotizing fasciitis using extracorporeal life support combined with hemoadsorption device and continuous renal replacement therapy

2018 ◽  
Vol 41 (3) ◽  
pp. 178-182 ◽  
Author(s):  
Maroua Eid ◽  
Olivier Fouquet ◽  
Cédric Darreau ◽  
Marc Pierrot ◽  
Achille Kouatchet ◽  
...  
Keyword(s):  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Necrotizing Fasciitis ◽  
Replacement Therapy ◽  
Organ Failure ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Blood Parameters ◽  
Multiple Organ ◽  
Superficial Fascia

Introduction: Necrotizing fasciitis represents a life-threatening infectious condition that causes spreading necrotisis of superficial fascia and subcutaneous cellular tissues. We describe the case of a patient diagnosed with septic and toxic shocks leading to multiple organ failure successfully treated with a combination of extracorporeal life support, continuous renal replacement therapy, and a hemoadsorption device. Methods: A 41-year-old patient presented with necrotizing fasciitis and multi-organ failure. Initial extracorporeal life support therapy was implanted, compensating for systolic failure. Due to acute renal failure that persisted in time, continuous renal replacement therapy was added. Despite these treatments and as a last attempt to control the septic condition, a CytoSorb® hemoadsorption device was installed in parallel to the extracorporeal life support circuit and two sessions were run. Results: During the days following CytoSorb® treatment, hemodynamic stabilization was observed, as well as normalization of lactic acidosis and blood parameters. Conclusion: This case describes the successful use of CytoSorb® with continuous renal replacement therapy and extracorporeal life support in a combined way to overcome a critical phase of septic shock in a young adult patient. This combination of treatments turned out to be efficient for this patient in the context of necrotizing fasciitis.

scholarly journals Current Aspect of Severe Malaria at the Infectious and Tropical Disease Service in Fann (Dakar)

2018 ◽  
Vol 2 (2) ◽  
Keyword(s):  
Multiple Organ Failure ◽  
Organ Failure ◽  
Severe Malaria ◽  
Poor Prognosis ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Multiple Organ ◽  
Current Profile ◽  
Who Criteria ◽  
Life Threatening

Background: Severe malaria occupies a significant place in Senegal. It is characterized by a multiple organ failure that is related to a very poor prognosis. The objective of this study was to determine the Current profile of severe malaria in the service of Tropical and Infectious Diseases of Fann Hospital in Dakar. Methods: A retrospective study was conducted regarding patients hospitalized between 2014 and 2016 for whom the diagnosis of severe malaria was established using WHO criteria of severity. Results: The number of cases of severe malaria was 176 cases, ie a hospital prevalence of 6%. The majority of patients were admitted between September and December. The median age averages 33 years [range: 11-86]. Nearly three-quarters of the patients were male (73.9%), a sex ratio of 2.8. Cerebral malaria was the most common (69.9%) and the most frequent signs of gravity were coma (68.2%), followed by jaundice (58.5%) and renal failure (29.6%). Hyperparasitaemia was noted in 13 cases. In all cases Plasmodium falciparum was the responsible parasite. Ninety-nine patients received quinine and 75 artesunate. Almost three quarters of patients (111 cases) had been hospitalized for up to 7 days. Case fatality rate reached 18.8%. Conclusion: Severe malaria is still responsible of multiple organ failure and a life-threatening disease. The most frequent sign of severity is coma but jaundice and renal impairment are increasingly high. Parenteral artesunate’s use is becoming consistent. Patients’ surviving artesunate should be investigated.

Multiple organ failure syndrome

1994 ◽  
Vol 14 (2) ◽  
pp. 25-26 ◽  
Author(s):  
E Reilly ◽  
CB Yucha
Keyword(s):  
Critical Care ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Metabolic Response ◽  
Clinical Status ◽  
Multiple Organ ◽  
Critical Care Nurses ◽  
Supportive Environment ◽  
Regulatory Aspects ◽  
Life Threatening

Although many new areas of research are directed at the regulatory aspects of the metabolic response, the prognosis of MOF remains poor. Critical care nurses, challenged to provide a supportive environment during this life-threatening syndrome, must understand its onset, clinical patterns, and prolonged support required by patients. Such knowledge will enable critical care nurses to detect subtle changes while monitoring clinical status, and facilitate timely interventions in order to decrease the morbidity and mortality associated with MOF.

scholarly journals Fatal septicemia caused by Chromobacterium violaceum in a child from Colombia

2007 ◽  
Vol 49 (6) ◽  
pp. 391-393 ◽  
Author(s):  
Pedro Martinez ◽  
Salim Mattar
Keyword(s):  
Septic Shock ◽  
Abdominal Pain ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Multiple Organ ◽  
Blood Cultures ◽  
Severe Abdominal Pain ◽  
Chromobacterium Violaceum ◽  
History Of ◽  
Fatal Septicemia

A 4-year old child living in Colombia presented with a history of fever and severe abdominal pain for four days. The patient developed pneumonia, septic shock, multiple organ failure and died on the fifth day of hospitalization. Chromobacterium violaceum was isolated from admission blood cultures and was resistant to ampicillin, cephalosporins, carbapenems and aminoglycosides.

scholarly journals Mallory- Weiss syndrome associated with new coronavirus infection COVID-19

2021 ◽  
pp. 175-180
Author(s):  
T. V. Goma ◽  
N. M. Kozlova ◽  
Yu. N. Bykov
Keyword(s):  
Duodenal Ulcer ◽  
Gastric Ulcer ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Clinical Case ◽  
Multiple Organ ◽  
Reduced Dose ◽  
History Of ◽  
Coronavirus Infection ◽  
D Dimer

The article presents a clinical case of the fatal Mallory- Weiss syndrome, which suddenly developed in an 86-year-old patient with a new coronavirus infection COVID-19, complicated by bilateral polysegmental pneumonia. The patient had no history of gastroesophageal refl ux disease, gastric ulcer or duodenal ulcer. The level of D-dimer on admission was elevated, but the patient was prescribed a reduced dose of anticoagulants (heparin). Despite the initial positive dynamics of the condition, the patient had a wave-like course of COVID-19, followed by the development of Mallory- Weiss syndrome, extremely severe post-hemorrhagic anemia and multiple organ failure, which became the cause of death.

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