Samanta Sukhen, Samanta Sujay, Haldar Rudrashish
Department of Critical Care Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Luckow, Uttar Pradesh, India.
Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Anaesth. 2014 Jan;58(1):55-8. doi: 10.4103/0019-5049.126797.
Malaria-leptospira co-infection is rarely detected. Emergency surgery in such patients has not been reported. We describe such a case of a 24-year-old primigravida at term pregnancy posted for emergency caesarean delivery who developed pulmonary haemorrhage, acute respiratory distress syndrome, acute kidney injury, and cerebral oedema. Here, we discuss the perioperative management, pain management (with transverse abdominis plane block), intensive care management (special reference to management of pulmonary haemorrhage with intra pulmonary factor VIIa) and the role of plasmapheresis in leptospira related jaundice with renal failure.
疟疾与钩端螺旋体共感染很少被检测到。此类患者的急诊手术尚未见报道。我们描述了这样一例病例，一名24岁足月妊娠初产妇因急诊剖宫产入院，出现了肺出血、急性呼吸窘迫综合征、急性肾损伤和脑水肿。在此，我们讨论围手术期管理、疼痛管理（采用腹横肌平面阻滞）、重症监护管理（特别提及肺内注射凝血因子VIIa治疗肺出血）以及血浆置换在钩端螺旋体相关黄疸伴肾衰竭中的作用。
