Pollack C V, Pender E S
Division of Emergency Medicine, University of Mississippi Medical Center, Jackson 39216-4505.
Ann Emerg Med. 1991 Dec;20(12):1366-70. doi: 10.1016/s0196-0644(05)81081-9.
Hemorrhagic shock and encephalopathy syndrome (HSES) is a devastating symptom complex that affects previously healthy infants and is associated with significant mortality and neurologic morbidity. The syndrome was first reported less than ten years ago, and there continues to be debate regarding whether HSES actually represents a distinct clinical entity or instead is a manifestation of heat illness, occult sepsis or endotoxic shock, or perhaps toxic ingestion. Nevertheless, the signs and symptoms described as HSES present in a typical fashion in the emergency department with sudden onset of shock, encephalopathy, seizures, and coagulopathy. Even with the initiation of intensive support in the ED, the outcome is probably dismal. We describe a case of HSES and review the presentation, proposed etiologies, and management of this catastrophic illness.
出血性休克和脑病综合征（HSES）是一种严重的症状复合体，影响先前健康的婴儿，与显著的死亡率和神经疾病发病率相关。该综合征在不到十年前首次被报道，关于HSES是否真的代表一种独特的临床实体，还是热疾病、隐匿性脓毒症或内毒素休克的表现，或者可能是中毒性摄入，一直存在争议。然而，以HSES描述的体征和症状在急诊科以典型方式出现，伴有休克、脑病、癫痫发作和凝血病的突然发作。即使在急诊科开始强化支持治疗，预后可能也很糟糕。我们描述了一例HSES病例，并回顾了这种灾难性疾病的临床表现、推测的病因及治疗。
