tailieunhanh - báo cáo khoa học: "Severe postpartum sepsis with prolonged myocardial dysfunction: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Severe postpartum sepsis with prolonged myocardial dysfunction: a case report | Mazzeffi and Chen Journal of Medical Case Reports 2010 4 318 http content 4 1 318 jAl JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Severe postpartum sepsis with prolonged myocardial dysfunction a case report Michael A Mazzeffi1 Katherine T Chen2 Abstract Introduction Severe sepsis during pregnancy or in the postpartum period is a rare clinical event. In non obstetric surviving patients the cardiovascular changes seen in sepsis and septic shock are fully reversible five to ten days after their onset. We report a case of septic myocardial dysfunction lasting longer than ten days. To the best of our knowledge this is the first report of prolonged septic myocardial dysfunction in a parturient. Case presentation A 24 year old Hispanic woman with no previous medical history developed pyelonephritis and severe sepsis with prolonged myocardial dysfunction after a normal spontaneous vaginal delivery. Conclusions Septic myocardial dysfunction may be prolonged in parturients requiring longer term follow up and pharmacologic treatment. Introduction Septic shock in obstetric patients is a rare clinical event. The estimated incidence is one in 8 338 deliveries 1 . In one case series of 18 obstetric patients that developed septic shock two thirds of patients were in the antepartum period and one third postpartum. The most common cause of septic shock was pyelonephritis and the most common pathogen isolated was Escherichia coli. Myocardial dysfunction was common among these patients. Another series included ten obstetric patients with septic shock and five patients 50 were found to have evidence of left ventricular dysfunction 2 . All patients had improvement in ventricular function during their hospitalization. Neither of these series however provided information on the duration of myocardial dysfunction in obstetric patients. In surviving non obstetric patients myocardial dysfunction has been shown to be fully reversible in five to ten .