Bouchaala Abderrahmane, Bourimi Chadi
Cardiology, University Hospital Ibn Sina, Rabat, MAR.
Urology A, University Hospital Ibn Sina, Rabat, MAR.
Cureus. 2024 Oct 28;16(10):e72560. doi: 10.7759/cureus.72560. eCollection 2024 Oct.
Septic cardiomyopathy (SCM) is a reversible cardiac dysfunction occurring in patients with sepsis or septic shock, characterized by transient impaired myocardial contractility. Despite its prevalence in severe sepsis and significant impact on patient outcomes, SCM remains underdiagnosed and is one of the least studied forms of cardiomyopathy. Its recognition and management are further complicated by the absence of a universally accepted consensus on its diagnostic criteria and definition. We report the case of a 54-year-old female presenting with septic shock secondary to xanthogranulomatous pyelonephritis (XGP). The patient presented with acute right lower back pain, fever, and hemodynamic instability. Initial echocardiography assessment demonstrated a preserved left ventricular ejection fraction (LVEF), which subsequently deteriorated following the onset of septic cardiomyopathy. Early recognition and management, including the use of vasopressors, inotropes, and judicious fluid resuscitation, resulted in full recovery of cardiac function within one week. This case highlights the importance of clinical vigilance and prompt intervention in the management of SCM, particularly in cases complicating severe infections such as XGP.
脓毒症性心肌病（SCM）是一种发生于脓毒症或脓毒性休克患者的可逆性心脏功能障碍，其特征为心肌收缩力短暂受损。尽管它在严重脓毒症中很常见且对患者预后有重大影响，但SCM仍未得到充分诊断，是研究最少的心肌病形式之一。由于对其诊断标准和定义缺乏普遍接受的共识，其识别和管理进一步复杂化。我们报告一例54岁女性患者，因黄色肉芽肿性肾盂肾炎（XGP）继发脓毒性休克。患者表现为急性右下背部疼痛、发热和血流动力学不稳定。初始超声心动图评估显示左心室射血分数（LVEF）正常，随后在脓毒症性心肌病发作后恶化。早期识别和管理，包括使用血管升压药、正性肌力药和谨慎的液体复苏，使心脏功能在一周内完全恢复。该病例强调了临床警惕性和及时干预在SCM管理中的重要性，特别是在诸如XGP等严重感染并发的病例中。
