暴发性钩端螺旋体性心肌炎一例：病例报告
An unusual case of fulminant leptospiral myocarditis: a case report.
作者信息
Khoo Chun Yuan, Ng Choon Ta, Zheng Shuwei, Teo Loon Yee
机构信息
Department of Cardiology, National Heart Centre, 5 Hospital Drive, Singapore 169609, Singapore.
Department of Infectious Diseases, Singapore General Hospital, Singapore 169608, Singapore.
出版信息
Eur Heart J Case Rep. 2019 Oct 21;3(4):1-5. doi: 10.1093/ehjcr/ytz180. eCollection 2019 Dec.
BACKGROUND
Fulminant myocarditis secondary to leptospirosis is rare and associated with poor outcomes.
CASE SUMMARY
We describe a 60-year-old gentleman with fulminant leptospiral myocarditis and profound cardiogenic shock requiring veno-arterial extracorporeal membrane oxygenator (VA-ECMO) support. He was given high-dose pulse steroids early on post-VA-ECMO implantation and achieved full recovery. To our knowledge, this is the first reported case of leptospiral myocarditis with multiorgan dysfunction successfully managed by VA-ECMO and high-dose pulse steroids.
DISCUSSION
This case report highlights the potential benefits of steroids in the management of leptospiral myocarditis which requires further validation. Early aggressive supportive management with ECMO should be considered in patients with fulminant leptospiral myocarditis.
背景
钩端螺旋体病继发的暴发性心肌炎罕见且预后不良。
病例摘要
我们描述了一名60岁男性，患有暴发性钩端螺旋体性心肌炎和严重的心源性休克，需要静脉-动脉体外膜肺氧合（VA-ECMO）支持。他在植入VA-ECMO后早期接受了大剂量脉冲类固醇治疗，并完全康复。据我们所知，这是首例成功通过VA-ECMO和大剂量脉冲类固醇治疗的伴有多器官功能障碍的钩端螺旋体性心肌炎病例。
讨论
本病例报告强调了类固醇在钩端螺旋体性心肌炎治疗中的潜在益处，这需要进一步验证。对于暴发性钩端螺旋体性心肌炎患者，应考虑早期积极使用ECMO进行支持治疗。
Zotero 插件