Fichte J, Neef V, Schöffner M, Bremerich D
Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Agaplesion Markus Krankenhaus, Wilhelm-Epstein-Str. 4, 60431, Frankfurt, Deutschland.
Anaesthesist. 2018 Oct;67(10):773-779. doi: 10.1007/s00101-018-0490-x. Epub 2018 Sep 26.
This article reports the fulminant course of a pneumogenic sepsis with severe ARDS (acute respiratory failure) in a 36-year-old female Indian patient, who died within 14 h after admission to the intensive care unit due to a multiorgan failure. During treatment the diagnosis of a miliary tuberculosis was suspected but was only confirmed by the autopsy. Due to high hygiene standards, miliary tuberculosis as the cause of septic shock is rare in Europe. Only 1-2% of the patients with pulmonary miliary tuberculosis develop an ARDS with a mortality of 60-90%. Based on this case the diagnostics as well as treatment of the patient are described. Furthermore, the management of an open tuberculosis on an intensive care unit is explained.
本文报道了一名36岁印度女性患者发生的由肺炎引起的脓毒症并伴有严重急性呼吸窘迫综合征（ARDS）的暴发性病程，该患者在入住重症监护病房后14小时内死于多器官功能衰竭。治疗期间怀疑患有粟粒性肺结核，但仅在尸检时得到证实。由于卫生标准较高，在欧洲，粟粒性肺结核作为感染性休克的病因较为罕见。仅有1%-2%的粟粒性肺结核患者会发展为ARDS，死亡率为60%-90%。基于该病例描述了患者的诊断和治疗情况。此外，还解释了在重症监护病房对开放性肺结核的管理。
