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大肠杆菌败血症和肠穿孔继发的败血症性心肌病：一名儿科患者的诊断挑战

Sepsis-Induced Cardiomyopathy Secondary to Escherichia coli Sepsis and Intestinal Perforation: A Diagnostic Challenge in a Paediatric Patient.

作者信息

Kumar Himanshu, Kumar Shishir, Nag Deb Sanjay, Diwakar Kumar, Singh Niharika

机构信息

Department of Anaesthesiology, Tata Main Hospital, Jamshedpur, IND.

Department of Surgery, Tata Main Hospital, Jamshedpur, IND.

出版信息

Cureus. 2024 Dec 29;16(12):e76552. doi: 10.7759/cureus.76552. eCollection 2024 Dec.

DOI:10.7759/cureus.76552
PMID:39881925
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11774630/
Abstract

A five-year-old male presented with abdominal pain, fever, vomiting, and constipation. Initial investigations suggested subacute intestinal obstruction. Laparotomy revealed intestinal perforation with peritonitis due to . Post-operatively, the patient developed sepsis-induced cardiomyopathy (SICM), requiring inotropic support and mechanical ventilation. The complex clinical presentation and overlap of symptoms with septic shock delayed the diagnosis of SICM, making timely identification challenging. This case highlights the diagnostic challenges in identifying sepsis-induced cardiomyopathy in the context of severe sepsis and abdominal pathology, underscoring the need for early recognition, particularly using echocardiography for myocardial dysfunction assessment.

摘要

一名五岁男性出现腹痛、发热、呕吐和便秘症状。初步检查提示亚急性肠梗阻。剖腹探查发现肠道穿孔并伴有腹膜炎，病因是……术后，患者发展为脓毒症诱发的心肌病（SICM），需要使用正性肌力药物支持和机械通气。复杂的临床表现以及与感染性休克症状的重叠延误了SICM的诊断，使得及时识别具有挑战性。该病例突出了在严重脓毒症和腹部病变背景下识别脓毒症诱发的心肌病的诊断挑战，强调了早期识别的必要性，特别是使用超声心动图评估心肌功能障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe7f/11774630/e69007ea51a9/cureus-0016-00000076552-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe7f/11774630/7f4f6880f1e9/cureus-0016-00000076552-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe7f/11774630/a495d0b4b8b4/cureus-0016-00000076552-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe7f/11774630/e69007ea51a9/cureus-0016-00000076552-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe7f/11774630/7f4f6880f1e9/cureus-0016-00000076552-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe7f/11774630/a495d0b4b8b4/cureus-0016-00000076552-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe7f/11774630/e69007ea51a9/cureus-0016-00000076552-i03.jpg

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本文引用的文献

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Sepsis-Induced Myocardial Dysfunction in Pediatric Septic Shock: Prevalence, Predictors, and Outcome-A Prospective Observational Study.小儿脓毒性休克中脓毒症诱导的心肌功能障碍：患病率、预测因素及结局——一项前瞻性观察研究
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Septic cardiomyopathy: Diagnosis and management.脓毒性心肌病：诊断与管理
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