Urology, All India Institute of Medical Sciences, New Delhi, Delhi, India
Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India.
BMJ Case Rep. 2022 Jul 5;15(7):e249814. doi: 10.1136/bcr-2022-249814.
A woman in her 30s had robotic pyeloplasty done for right ureteropelvic junction obstruction. Incidentally she developed dengue viral fever starting on postoperative day 1 itself, which progressed to dengue haemorrhagic shock by 1 week, complicating pyeloplasty due to pelvicalyceal haematoma. Dengue associated shock was superimposed with subsequent gram-negative bacterial sepsis, further complicated later with Trichosporon fungal sepsis. She was managed under multidisciplinary care, involving urology, infectious disease and ICU care. Her diagnostic and difficult management issues due to these rare sequential medical issues in an otherwise usually uncomplicated postsurgical phase are discussed along with short review of literature. This case highlights the importance of early diagnosis, timely supportive care and appropriate management in such tropical infections with significant associated mortality.
一位 30 多岁的女性因右侧输尿管肾盂连接部梗阻接受了机器人肾盂成形术。碰巧的是，她在术后第 1 天开始出现登革热病毒感染，到第 1 周时进展为登革出血性休克，并发肾盂积血导致肾盂成形术复杂化。肾盂积血继发于革兰氏阴性菌败血症，随后又并发毛孢子菌败血症。她在多学科的治疗下进行治疗，包括泌尿科、传染病科和重症监护病房的治疗。由于这些罕见的连续医疗问题在通常无并发症的术后阶段发生，因此对她的诊断和困难的管理问题进行了讨论，并对文献进行了简短的回顾。这个病例强调了在这些具有显著相关死亡率的热带感染中，早期诊断、及时的支持性护理和适当管理的重要性。
