Obreja Maria, Teodor Andra, Leca Daniela, Ceasovschih Alexandr, Miftode Egidia
"Sfânta Parascheva" Infectious Diseases Hospital Iași, Iași, România.
"Grigore T. Popa"University of Medicine and Pharmacy, Iași, România.
J Crit Care Med (Targu Mures). 2016 May 9;2(2):93-95. doi: 10.1515/jccm-2016-0013. eCollection 2016 Apr.
Jaundice in sepsis is usually caused by cholestasis, and its onset can precede other manifestations of the infection. Inflammation-induced cholestasis is a common complication in patients with an extrahepatic infection or those with inflammatory processes. We describe the case of a 47 years old female who presented with low back pain and paravertebral muscular contracture. She subsequently developed a cholestatic syndrome with clinical manifestations such as jaundice, followed by fever and sepsis with multiple organ dysfunction. Initially labeled as biliary sepsis, the diagnosis was crucially reoriented as the blood cultures were positive for Streptococcus pyogenes and the magnetic resonance imaging (MRI) findings suggested spondylodiscitis as well as a paravertebral abscess.
脓毒症中的黄疸通常由胆汁淤积引起，其发作可能先于感染的其他表现。炎症诱导的胆汁淤积是肝外感染患者或有炎症过程患者的常见并发症。我们描述了一名47岁女性的病例，她最初表现为腰痛和椎旁肌肉挛缩。随后她出现了胆汁淤积综合征，临床表现为黄疸，接着是发热和伴有多器官功能障碍的脓毒症。最初被诊断为胆源性脓毒症，随着血培养结果显示化脓性链球菌阳性，且磁共振成像（MRI）结果提示存在脊椎椎间盘炎以及椎旁脓肿，诊断发生了关键的重新定位。
