夏季发生的与流感相关的感染性休克伴感染性心肌病，临床表现类似暴发性心肌炎。
Influenza-associated septic shock accompanied by septic cardiomyopathy that developed in summer and mimicked fulminant myocarditis.
作者信息
Fujioka Masaki, Suzuki Kei, Iwashita Yoshiaki, Imanaka-Yoshida Kyoko, Ito Masaaki, Katayama Naoyuki, Imai Hiroshi
机构信息
The Emergency and Critical Care Center Mie University Hospital Tsu Mie Japan.
Department of Cardiology and Nephrology Mie University Graduate School of Medicine Tsu Mie Japan.
出版信息
Acute Med Surg. 2019 Feb 10;6(2):192-196. doi: 10.1002/ams2.394. eCollection 2019 Apr.
CASE
Fulminant myocarditis (FM) and septic cardiomyopathy (SC) are two different disease entities, and distinction between them is important. A 34-year-old man had refractory shock, multiple organ failure, and elevation of cardiogenic markers. Echocardiogram showed tachycardia with extended ST elevation, and a rapid test for influenza A virus was positive. He was admitted with suspected FM induced by influenza.
OUTCOME
Echocardiography showed severe left ventricular dysfunction and dilatation, but no myocardial edema. Inconsistent with FM, a right heart catheter examination showed preserved cardiac output. Therefore, SC was considered and standard therapy for septic shock was initiated. He was stabilized in the first 72 h without mechanical circulatory support.
CONCLUSION
Influenza A infection can cause septic shock accompanied by SC. This condition is confusing in the clinical appearance of FM. However, SC shows critically different features of FM, and it might not occur in the epidemic period.
病例
暴发性心肌炎（FM）和脓毒症性心肌病（SC）是两种不同的疾病实体，区分它们很重要。一名34岁男性出现难治性休克、多器官功能衰竭以及心源性标志物升高。超声心动图显示心动过速伴ST段广泛抬高，甲型流感病毒快速检测呈阳性。他因疑似流感诱发的FM入院。
结果
超声心动图显示严重左心室功能障碍和扩张，但无心肌水肿。与FM不符的是，右心导管检查显示心输出量正常。因此考虑为SC，并开始了脓毒症性休克的标准治疗。他在最初72小时内病情稳定，无需机械循环支持。
结论
甲型流感感染可导致伴有SC的脓毒症性休克。这种情况在FM的临床表现中具有迷惑性。然而，SC表现出与FM截然不同的特征，且可能不在流行期发生。
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