scholarly journals Emergency Management of Unexpected Life-Threatening Septic Shock in a Patient Undergoing Ureteroscopic Stone Removal

2018 ◽  
Vol 09 (02) ◽  
Author(s):  
Nihar Ranjan Tripathy ◽  
Sabyasachi Tripathy
Keyword(s):  
Septic Shock ◽  
Emergency Management ◽  
Stone Removal ◽  
Life Threatening

Effect of Undertriage on the Outcomes of Cancer Patients with Febrile Neutropenia, Sepsis, and Septic Shock

2021 ◽  
pp. 105477382199968
Author(s):  
Anas Alsharawneh
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Length Of Stay ◽  
Febrile Neutropenia ◽  
Cancer Patients ◽  
Emergency Setting ◽  
Extended Length ◽  
Life Threatening ◽  
Sepsis And Septic Shock ◽  
Timely Treatment

Sepsis and neutropenia are considered the primary life-threatening complications of cancer treatment and are the leading cause of hospitalization and death. The objective was to study whether patients with neutropenia, sepsis, and septic shock were identified appropriately at triage and receive timely treatment within the emergency setting. Also, we investigated the effect of undertriage on key treatment outcomes. We conducted a retrospective analysis of all accessible records of admitted adult cancer patients with febrile neutropenia, sepsis, and septic shock. Our results identified that the majority of patients were inappropriately triaged to less urgent triage categories. Patients’ undertriage significantly prolonged multiple emergency timeliness indicators and extended length of stay within the emergency department and hospital. These effects suggest that triage implementation must be objective, consistent, and accurate because of the several influences of the assigned triage scoring on treatment and health outcomes.

scholarly journals Meningitis, spondylodiscitis, pneumonia and septic shock with Streptococcus pneumoniae in a previously healthy woman with isolated IgG2-, IgG3-, IgA-deficiency and monoclonal gammopathy of undetermined significance

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Shahin Gaini ◽  
David Gudnason ◽  
Bjarni á Steig ◽  
Jenny Jónsdóttir Nielsen
Keyword(s):  
Septic Shock ◽  
Monoclonal Gammopathy ◽  
Left Lung ◽  
Healthy Woman ◽  
Caucasian Woman ◽  
Vaccine Response ◽  
Pneumococcal Infections ◽  
Prophylactic Measures ◽  
Life Threatening ◽  
Undetermined Significance

A 66 years old Caucasian woman with pneumococcal meningitis was treated and discharged after an uncomplicated course. Five months later she was readmitted withfever and right side abdominal pain and diagnosed with pneumococcal spondylodiscitis. One year later she was treated fora severe chest X-ray confirmed left lobar pneumonia. Two years later she was diagnosed with a pneumococcal pneumonia inher left lung with septic shock. An immunedeficiency screen revealed slightly reduced IgA levels, low IgG2 levels, low IgG3 levels and high IgG1 levels. No other immunedefects were identified. She did not respondserologically on vaccination with 13-valentconjugate and 23-valent polysaccharide pneumococcal vaccines. Further evaluations revealed a positive M-component inher blood and a bone marrow biopsy diagnosed her to have monoclonal gammopathy of undetermined significance. To protecther against future life threatening pneumococcal infections she was started on treatment with intravenous immunoglobulin. The case report illustrates the importance of thorough evaluation of patients with unusual infectious disease entities or unusual frequency of infections in individual patients. To optimize prophylactic measures and active treatment options in the individual patient, it is important to identify underlying causes of diseases and immune deficiencies that potentially can lead to life threatening infections. This is illustrated inour case by an undiagnosed monoclonal gammopathy of undetermined significancein an apparently healthy woman with atleast three life threatening documented pneumococcal infections in a two-year period and poor pneumococcal vaccine response

scholarly journals Bowel infarct with mucormycosis of the intestine

2019 ◽  
Vol 6 (7) ◽  
pp. 2609 ◽  
Author(s):  
Bharat Sangal ◽  
Rajeev Sharma ◽  
Molly Joseph ◽  
Debarghya Chatterjee
Keyword(s):  
Septic Shock ◽  
Fungal Infection ◽  
Male Patient ◽  
Adult Male ◽  
Bowel Infarction ◽  
Life Threatening ◽  
Cerebral Infection ◽  
Adult Male Patient

Gastrointestinal mucormycosis is a relatively uncommon opportunistic fungal infection. The classical presentation is that of a rhino-cerebral infection. It is a life threatening, angio-invasive condition typically affecting immunocompromised individuals. Only a handful cases of intestinal mucormycosis have been reported to date. Here, we discuss our experience regarding an adult male patient who succumbed to bowel infarction and perforation with septic shock due to intestinal mucormycosis.

Septic Shock: Phenomenology

1971 ◽  
Vol 2 (4) ◽  
pp. 327-332
Author(s):  
Roy G. Fitzgerald
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Endotoxin Shock ◽  
Life Threatening ◽  
The Moment

This is an autobiographical account of an episode of life-threatening endotoxin shock experienced in the intensive care unit of a university-affiliated V.A. hospital. It was written within a day of the event by a psychiatrist interested in sharing with other physicians and nurses his harrowing time as a patient. He has added some afterthoughts as his perspective has broadened. The account presents the moment-to-moment events as he perceived them as well as his thoughts, feelings and fantasies. The ambiguities of being a psychiatrist-patient with its passivity-control, intellectual defenses, denial and fears of death are prominent in his thoughts.

Assessment and care of the patient with sepsis

2020 ◽  
pp. 225-257
Author(s):  
Kevin Barrett
Keyword(s):  
Septic Shock ◽  
Early Recognition ◽  
Scoring Systems ◽  
Cardiovascular Responses ◽  
Physiological Changes ◽  
Assessment Framework ◽  
Threatening Condition ◽  
Life Threatening ◽  
Support Mechanisms ◽  
Sepsis And Septic Shock

There has been considerable recent focus on sepsis in both the clinical arena and within the general public to raise awareness of the importance of early recognition of this potentially life-threatening condition. The early recognition of sepsis by ward nurses can both reduce progression of this lethal disease and improve survival for patients in hospital. This chapter focuses on definitions of sepsis and septic shock, physiological changes associated with inflammatory and cardiovascular responses to sepsis, and a clinical assessment framework to guide practice. There is also a discussion of the use of scoring systems and how to escalate support mechanisms for patients with sepsis and septic shock.

Hypotension

2018 ◽  
pp. 163-167
Author(s):  
Angela Creditt
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Organ Failure ◽  
Broad Spectrum ◽  
Signs And Symptoms ◽  
Intravenous Fluids ◽  
Key Points ◽  
Life Threatening ◽  
New Guidelines ◽  
Sepsis And Septic Shock

Sepsis is a complex and potentially life-threatening sequela of infection that commonly occurs and can be difficult to identify. If unrecognized or undertreated, sepsis can progress to severe sepsis, septic shock, characterized by hypotension and multisystem organ failure, and ultimately death. This case illustrates classic signs and symptoms of sepsis and septic shock in a postoperative patient. Recognizing these symptoms, rapidly initiating resuscitation with intravenous fluids and broad-spectrum antibiotics and aggressive management of these patients is imperative to prevent further decompensation. In 2017, the Surviving Sepsis campaign published new guidelines to assist with the management of patients with sepsis and septic shock. Key points from these guidelines will be highlighted within this case.

scholarly journals Favorable 90-Day Mortality in Obese Caucasian Patients with Septic Shock According to the Sepsis-3 Definition

2019 ◽  
Vol 9 (1) ◽  
pp. 46 ◽  
Author(s):  
Caspar Mewes ◽  
Carolin Böhnke ◽  
Tessa Alexander ◽  
Benedikt Büttner ◽  
José Hinz ◽  
...  
Keyword(s):  
Septic Shock ◽  
Protective Effect ◽  
Cox Regression ◽  
Obese Patients ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Threatening Condition ◽  
Life Threatening ◽  
Caucasian Patients ◽  
Patient Prognosis

Septic shock is a frequent life-threatening condition and a leading cause of mortality in intensive care units (ICUs). Previous investigations have reported a potentially protective effect of obesity in septic shock patients. However, prior results have been inconsistent, focused on short-term in-hospital mortality and inadequately adjusted for confounders, and they have rarely applied the currently valid Sepsis-3 definition criteria for septic shock. This investigation examined the effect of obesity on 90-day mortality in patients with septic shock selected from a prospectively enrolled cohort of septic patients. A total of 352 patients who met the Sepsis-3 criteria for septic shock were enrolled in this study. Body-mass index (BMI) was used to divide the cohort into 24% obese (BMI ≥ 30 kg/m2) and 76% non-obese (BMI < 30 kg/m2) patients. Kaplan-Meier survival analysis revealed a significantly lower 90-day mortality (31% vs. 43%; p = 0.0436) in obese patients compared to non-obese patients. Additional analyses of baseline characteristics, disease severity, and microbiological findings outlined further statistically significant differences among the groups. Multivariate Cox regression analysis estimated a significant protective effect of obesity on 90-day mortality after adjustment for confounders. An understanding of the underlying physiologic mechanisms may improve therapeutic strategies and patient prognosis.

scholarly journals CXCL5-mediated recruitment of neutrophils into the peritoneal cavity ofGdf15-deficient mice protects against abdominal sepsis

2020 ◽  
Vol 117 (22) ◽  
pp. 12281-12287 ◽  
Author(s):  
Isa Santos ◽  
Henrique G. Colaço ◽  
Ana Neves-Costa ◽  
Elsa Seixas ◽  
Tiago R. Velho ◽  
...  
Keyword(s):  
Septic Shock ◽  
Organ Dysfunction ◽  
Peritoneal Cavity ◽  
Host Response ◽  
Abdominal Sepsis ◽  
Neutrophil Recruitment ◽  
Life Threatening ◽  
Pathogen Control ◽  
Circulating Levels ◽  
Deficient Mice

Sepsis is a life-threatening organ dysfunction condition caused by a dysregulated host response to an infection. Here we report that the circulating levels of growth and differentiation factor-15 (GDF15) are strongly increased in septic shock patients and correlate with mortality. In mice, we find that peptidoglycan is a potent ligand that signals through the TLR2-Myd88 axis for the secretion of GDF15, and thatGdf15-deficient mice are protected against abdominal sepsis due to increased chemokine CXC ligand 5 (CXCL5)-mediated recruitment of neutrophils into the peritoneum, leading to better local bacterial control. Our results identify GDF15 as a potential target to improve sepsis treatment. Its inhibition should increase neutrophil recruitment to the site of infection and consequently lead to better pathogen control and clearance.

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