scholarly journals Lemierre’s syndrome, necrotizing pneumonia and staphylococcal septic shock treated with extracorporeal life support

2017 ◽  
Vol 5 ◽  
pp. 2050313X1772272
Author(s):  
Adrian C Mattke ◽  
Sudesh Prabhu ◽  
Julia Clark ◽  
Robert Labrom ◽  
Hanna Burns ◽  
...  
Keyword(s):  
Septic Shock ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Source Control ◽  
Necrotizing Pneumonia ◽  
Lemierre’S Syndrome ◽  
Vertebral Bodies ◽  
Lemierre's Syndrome ◽  
Prolonged Hospital

Objectives: Lemierre’s syndrome cause by methicillin-sensitive Staphylococcus aureus is rare, but can lead to necrotizing pneumonia and septicaemia. When treating such patient with extracorporeal life support source control can be both challenging and controversial. Methods: In this report we present a 12 year old male who presented with Lemierre’s syndrome from which he developed septic shock and severe necrotizing pneumonia. He also showed multiple pulmonary embolisms from the internal jugular vein thrombi, resulting in acute respiratory distress syndrome. Results: The patient was treated with extracorporeal life support. Subsequent computed tomography revealed multiple abscesses throughout his lungs and around vertebral bodies C1 and C2, for which source control with drainage of the cervical abscesses was achieved while on extracorporeal life support. The necrotizing pneumonia gradually improved, and partial pneumectomy was avoided. He was successfully separated from extracorporeal life support and respiratory support and recovered from his illness. Follow-up imaging showed almost complete resolution of the pulmonary abscesses. Osteomyelitis of C1/C2 and severe muscle wasting required a prolonged hospital stay. Conclusion: This case highlights the challenges of supporting patients suffering from disseminated staphylococcal sepsis with extracorporeal life support and the key role of source control and demonstrates the value of using extracorporeal life support in necrotizing pneumonia.

scholarly journals Early Diagnosis and Antibiotic Treatment Combined with Multicomponent Hemodynamic Support for Addressing a Severe Case of Lemierre’s Syndrome

Antibiotics ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1526
Author(s):  
Andreaserena Recchia ◽  
Marco Cascella ◽  
Sabrina Altamura ◽  
Felice Borrelli ◽  
Nazario De Nittis ◽  
...  
Keyword(s):  
Septic Shock ◽  
Severe Case ◽  
Organ Damage ◽  
Source Control ◽  
Lemierre’S Syndrome ◽  
Upper Respiratory Infection ◽  
Systemic Involvement ◽  
Hemodynamic Optimization ◽  
Proper Diagnosis ◽  
Lemierre's Syndrome

A 20-year-old man was admitted to the intensive care unit for septic shock due to Lemierre’s syndrome. It is a rare syndrome that manifests as an upper respiratory infection, although systemic involvement, severe coagulopathy, and multi-organ failure can dangerously complicate the clinical picture. In this syndrome, sepsis-related neuroendocrine dysregulation and microcirculation impairment can have a rapid deleterious progression. Consequently, proper diagnosis, early source control, and appropriate antibiotics administration are mandatory to improve the prognosis. The intensive treatment is aimed at limiting organ damage through hemodynamic optimization. Remarkably, in septic shock due to Lemierre’s syndrome, hemodynamic optimization can be achieved through the synergic effect of norepinephrine, argipressin, and hydrocortisone.

scholarly journals Thrombotic thrombocytopenic purpura presenting as a severe peripartum cardiogenic shock: Role of myocardial biopsy and assist device for diagnosis and resuscitation

2017 ◽  
Vol 9 (7) ◽  
pp. NP8-NP9 ◽  
Author(s):  
Sébastien Champion ◽  
Dominique Belcour ◽  
Bernard Alex Gaüzère
Keyword(s):  
Cardiogenic Shock ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Cardiac Involvement ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Complete Recovery ◽  
Myocardial Biopsy ◽  
Assist Device ◽  
Thrombocytopenic Purpura

We describe the case of a peripartum thrombotic thrombocytopenic purpura with fulminant cardiogenic shock treated with extracorporeal life support. Thrombotic thrombocytopenic purpura should be considered in the case of thrombotic microangiopathy with several or severe organ involvement and needs emergent treatment with plasmapheresis (with or without rituximab). In the case of cardiac involvement, aggressive treatment should be considered given the high mortality and the potential complete recovery.

scholarly journals Reply to: The role of extracorporeal life support in patients with hypothermic cardiac arrest

Resuscitation ◽  
2019 ◽  
Vol 134 ◽  
pp. 159-160
Author(s):  
Michael M. Beyea ◽  
Bourke W. Tillmann ◽  
A. Dave Nagpal
Keyword(s):  
Cardiac Arrest ◽  
Life Support ◽  
Extracorporeal Life Support

scholarly journals Treatment of Polypharmacy Overdose with Multimodality Extracorporeal Life Support

2005 ◽  
Vol 33 (1) ◽  
pp. 120-123 ◽  
Author(s):  
G. Maclaren ◽  
W. Butt ◽  
P. Cameron ◽  
A. Preovolos ◽  
R. Mcegan ◽  
...  
Keyword(s):  
Emergency Department ◽  
Life Support ◽  
Slow Release ◽  
Extracorporeal Life Support ◽  
Tertiary Referral ◽  
Severe Metabolic Acidosis ◽  
Verapamil Overdose ◽  
Tertiary Referral Hospital ◽  
Venoarterial Extracorporeal Membrane Oxygenation

A 45-year-old woman presented to the emergency department of a tertiary referral hospital after taking an overdose of verapamil, doxepin, quetiapine, diazepam, temazepam, and clonazepam. She rapidly developed shock refractory to pharmacological support and was placed on percutaneous venoarterial extracorporeal membrane oxygenation (ECMO). She had a severe metabolic acidosis from a combination of shock and drug intoxication that improved with continuous venovenous haemodialysis. Forty-eight hours after presentation, while still on ECMO, the patient had complete cardiac standstill for three and a half hours, attributable to slow-release verapamil, that resolved after the commencement of plasmapheresis. The role of plasmapheresis in verapamil overdose requires further study.

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