Chest Infections: Chest Infections II |

Severe Pneumonia and Septic Shock FREE TO VIEW

Xiaoyan Sun, MS; Bei He, PhD; Ning Shen, PhD; Yan Ding, PhD; Chun Chang, PhD
Author and Funding Information

Peking University Third Hospital, Beijing, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A119. doi:10.1016/j.chest.2016.02.124
Text Size: A A A
Published online

SESSION TITLE: Chest Infections II

SESSION TYPE: Case Report Poster

PRESENTED ON: Sunday, April 17, 2016 at 11:45 AM - 12:45 PM

INTRODUCTION: Septic shock is systemic inflammatory responses caused by interaction between the host immune system and microorganisms with high mortality. The most common sources of infection are respiratory and abdomina. And the most common pathogens of pneumonia that lead to septic shock are gram negative bacilli early, goal-directed resuscitation for septic shock and China's severe sepsis/septic shock treatment guidelines of 2014 was published which gives a great help for the clinical treatment of septic shock.

CASE PRESENTATION: A 38-year-old women, who had a fever for 7days, and dyspnea for 2days. Her past medical history was hypothyroidism. We had the diagnoses of respiratory failure of type I, severe pneumonia. Our immediate empiric antimicrobial therapy was ertapenem combined levofloxacin. On the third day of hospitalization, her dyspnea exacerbated with the temperature of 40℃, BP 77/47mmHg. She was transferred to the RICU and was given fluid resuscitation, vasopressors intubated and mechanically ventilated, but she remained persistently hypotensive, oxygen saturation could’t be messured.we completed ECMO by the bed, the shock was gradually corrected. We adjusted the antibiotics according to the sputum culture. and did some support treatments. Then cerebral hemorrhage and subarachnoid hemorrhage, bloodstream infection, puncture wound infection occured. She finally died in septic shock.

DISCUSSION: The patient’s septic shock was caused by severe pneumonia. We had corrected the shock and adjusted antibiotic therapy according to the result of drug sensitive test. Then bloodstream infection and puncture wound infection presented, contributed to the disease progression and the death. With increased drug resistance of these bacteria, antibiotic therapy is more and more difficult. The antibiotics we used are broad spectrum and sensitive to the bacteria, but the patient had a poor therapeutic outcome. We think it may have a relationship with the bad base state of the patient and more complications. In the later stage of the treatment, the patient had cerebral hemorrhage and subarachnoid hemorrhage, the reason might be the low level of platelet caused by bone marrow inhibition. So we should positively complement the blood products in the treatment of septic shock and make the amount of platelet reach the standard.

CONCLUSIONS: Due to the high mortality of septic shock, it is important to have a comprehensive therapy, especially in initial empiric antibiotic therapy which should have a universal coverage of the pathogenic bacteria and the effective prevention of the complications.

Reference #1: China's severe sepsis/septic shock treatment guidelines. Chin Crit Care Med, June 2015, Vol.27, No.6.

Reference #2: Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock, 2012. Intensive Care Med (2013) 39:165-228.

Reference #3: Qiang Chen, Xiaozhen Jiang, Guagju Zhao.ect. Mortality and risk factors of septic shock in 159 patients in emergency intensive care unit. J Med Res, Feb 2012, Vol. 41 No. 2.

DISCLOSURE: The following authors have nothing to disclose: Xiaoyan Sun, Bei He, Ning Shen, Yan Ding, Chun Chang

No Product/Research Disclosure Information




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543