Ingram Toyin, Evbuomwan Moses O, Jyothidasan Amudhan
Internal Medicine, Cape Fear Valley Health, Fayetteville, USA.
Radiation Oncology, University of Iowa, Iowa, USA.
Cureus. 2024 Apr 10;16(4):e57951. doi: 10.7759/cureus.57951. eCollection 2024 Apr.
Sepsis is a medical emergency that describes the body's systemic immunological response to an infectious process that can lead to end-stage organ dysfunction and death. Sepsis-induced cardiomyopathy (SICM) is an increasingly recognized form of transient cardiac dysfunction characterized by left ventricular dilation, depressed ejection fraction, and recovery in 10 days without cardiac-related medical intervention. Injury to the myocardium by inflammatory cytokines has been proposed as one of the main causative mechanisms. Human metapneumovirus (hMPV) is a paramyxovirus and a common cause of respiratory tract infection that has been reported to modulate chemical mediators that produce inflammatory cytokines. Extra-pulmonary cardiac complications of hMPV have been reported; but literature on SICM associated with hMPV are very rare. We describe a case of a 43-year-old male with no known cardiac history diagnosed with SICM associated with hMPV. His sepsis was managed in the intensive care unit, and his heart ejection fraction improved within 10 days without the initiation of guideline-directed medical therapy.
脓毒症是一种医疗急症,描述的是机体对感染过程的全身性免疫反应,这种反应可导致终末期器官功能障碍和死亡。脓毒症诱发的心肌病(SICM)是一种越来越被认可的短暂性心脏功能障碍形式,其特征为左心室扩张、射血分数降低,且在无心脏相关医疗干预的情况下10天内可恢复。炎性细胞因子对心肌的损伤被认为是主要致病机制之一。人偏肺病毒(hMPV)是一种副粘病毒,是呼吸道感染的常见病因,据报道它可调节产生炎性细胞因子的化学介质。hMPV的肺外心脏并发症已有报道;但与hMPV相关的SICM的文献非常罕见。我们描述了一例43岁无已知心脏病史的男性病例,该患者被诊断为与hMPV相关的SICM。他的脓毒症在重症监护病房得到治疗,且在未开始指南指导的药物治疗的情况下,其心脏射血分数在10天内得到改善。