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流感嗜血杆菌引起的暴发性紫癜合并可逆性心肌病 1 例。

A case of purpura fulminans caused by Hemophilus influenzae complicated by reversible cardiomyopathy.

机构信息

Trauma and Acute Critical Care Medical Center, Medical Hospital of Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519 Japan.

Department of Intensive Care Medicine, Kameda Medical Center, Kamogawa, Chiba, 296-8602 Japan ; UQ Centre for Clinical Research, The University of Queensland, Herston, Brisbane, St Lucia Queensland, 4072 Australia.

出版信息

J Intensive Care. 2014 Feb 18;2(1):13. doi: 10.1186/2052-0492-2-13. eCollection 2014.

Abstract

Here, we report a case of a 41-year-old male diagnosed as septic shock with purpura fulminans (PF) infection. The causative organism was β-lactamase-negative ampicillin-resistant Hemophilus influenzae. He developed fulminant cardiac dysfunction approximately 1 h after admission, and the cause was considered to be septic cardiomyopathy. Blood pressure and oxygenation were maintained at adequate levels with the aid of extracorporeal membrane oxygenation (ECMO). The cardiac dysfunction was reversible, and he was successfully weaned from ECMO on day 12 of hospitalization. However, he needed amputation for all extremities because the infection spread to his limbs and eventually, succumbed to sepsis caused by empyema on day 34 of hospitalization. To the best of our knowledge, this is only the second case of PF caused by H. influenzae in an adult to be reported worldwide.

摘要

在这里,我们报告了一例 41 岁男性患者,被诊断为感染性休克伴暴发性紫癜(PF)。病原体为β-内酰胺酶阴性、氨苄西林耐药流感嗜血杆菌。他在入院后约 1 小时出现暴发性心功能障碍,原因被认为是感染性心肌病。体外膜氧合(ECMO)的辅助使血压和氧合维持在足够的水平。心功能障碍是可逆的,他在住院第 12 天成功地从 ECMO 脱机。然而,由于感染扩散到四肢,他需要对所有四肢进行截肢,最终在住院第 34 天因脓胸导致败血症而死亡。据我们所知,这是全球第二例成人由流感嗜血杆菌引起的 PF 病例报告。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d76/4267704/5450c537ee2f/40560_2013_27_Fig1_HTML.jpg

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