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伴有深静脉血栓形成和双侧胸腔积液的脓毒性肺栓塞

Septic Pulmonary Embolism With Deep Vein Thrombosis and Bilateral Pleural Effusion.

作者信息

Mayekar Mrinmayee V, Jadhav Ulhas S, Ghewade Babaji, Wagh Pankaj B, Aurangabadkar Gaurang M

机构信息

Respiratory Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.

Respiratory Medicine, Datta Meghe Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.

出版信息

Cureus. 2022 Sep 21;14(9):e29437. doi: 10.7759/cureus.29437. eCollection 2022 Sep.

DOI:10.7759/cureus.29437
PMID:36299944
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9587383/
Abstract

Septic emboli induce two insults - firstly, the infectious insult, which causes inflammation and increases the potential for abscess formation, and secondly, the early embolic/ischemic insult brought on by arterial blockage and infarction. Pulmonary embolism is the second leading cause of cardiovascular disease-associated death, right after cardiovascular events. The sequelae of venous thromboembolism include post-thrombotic syndrome and chronic thromboembolic pulmonary hypertension (CTEPH). The pathophysiological characteristics of inflammation, hypercoagulability, and endothelial damage are the three components of Virchow's triad, which are mirrored by the risk factors for both diseases. The screening of patients for whom venous thromboembolism can be ruled out with a positive plasma D-dimer test result is made easier by clinical probability evaluation. To confirm the diagnosis, compression ultrasonography that displays deep vein thrombosis or a chest CT that reveals pulmonary embolism have been frequently employed. We report a case of a young male who presented with sudden onset pain and swelling in the left lower limb and chest following an intramuscular injection which further resulted in pulmonary thromboembolism.

摘要

脓毒性栓子会引发两种损伤——首先是感染性损伤,它会导致炎症并增加脓肿形成的可能性;其次是由动脉阻塞和梗死引起的早期栓塞/缺血性损伤。肺栓塞是仅次于心血管事件的心血管疾病相关死亡的第二大原因。静脉血栓栓塞的后遗症包括血栓形成后综合征和慢性血栓栓塞性肺动脉高压(CTEPH)。炎症、高凝状态和内皮损伤的病理生理特征是维勒三联征的三个组成部分,这两种疾病的危险因素也反映了这一点。通过临床概率评估,对于血浆D - 二聚体检测结果为阳性但可排除静脉血栓栓塞的患者进行筛查变得更加容易。为了确诊,经常采用显示深静脉血栓形成的加压超声检查或显示肺栓塞的胸部CT检查。我们报告了一例年轻男性病例,该患者在肌肉注射后出现左下肢和胸部突然疼痛和肿胀,进而导致肺血栓栓塞。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3782/9587383/2eb381c3eb28/cureus-0014-00000029437-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3782/9587383/c3e1a5a78bb2/cureus-0014-00000029437-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3782/9587383/8536bab03f52/cureus-0014-00000029437-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3782/9587383/7c2a528786f1/cureus-0014-00000029437-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3782/9587383/2eb381c3eb28/cureus-0014-00000029437-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3782/9587383/c3e1a5a78bb2/cureus-0014-00000029437-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3782/9587383/8536bab03f52/cureus-0014-00000029437-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3782/9587383/7c2a528786f1/cureus-0014-00000029437-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3782/9587383/2eb381c3eb28/cureus-0014-00000029437-i04.jpg

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本文引用的文献

1
Clinical characteristics of septic pulmonary embolism in adults: a systematic review.成人感染性肺栓塞的临床特征:一项系统评价
Respir Med. 2014 Jan;108(1):1-8. doi: 10.1016/j.rmed.2013.10.012. Epub 2013 Oct 17.
2
Pulmonary embolism and deep vein thrombosis.肺栓塞与深静脉血栓形成。
Lancet. 2012 May 12;379(9828):1835-46. doi: 10.1016/S0140-6736(11)61904-1. Epub 2012 Apr 10.
3
Septic Pulmonary Embolism Case Report: Optimal Outcome after Insertion of an Inferior Vena Cava Filter in a Patient with Staphylococcus aureus Bacteraemia.
脓毒性肺栓塞病例报告:金黄色葡萄球菌菌血症患者植入下腔静脉滤器后的最佳治疗效果
Int J Pediatr. 2010;2010:651023. doi: 10.1155/2010/651023. Epub 2010 Jun 7.
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Cavitary pulmonary disease.空洞性肺疾病
Clin Microbiol Rev. 2008 Apr;21(2):305-33, table of contents. doi: 10.1128/CMR.00060-07.