[Sepsis with hemolysis due to a liver abscess in a 60-year-old male patient].

4区 医学 Q3 Medicine Internist Pub Date : 2022-03-01 Epub Date: 2022-01-03 DOI:10.1007/s00108-021-01227-2
H Lang, J J Schmidt, H Wedemeyer, M Busch
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引用次数: 1

Abstract

Many cases of Clostridium perfringens sepsis prove to be fatal. We present a case of C. perfringens sepsis with a liver abscess as the focus of infection, which was successfully treated by an interdisciplinary intensive medical care management. The sepsis with this rare pathogen was favored by the presence of a bilioenteric anastomosis and immunosuppressive treatment of a pre-existing Crohn's disease. Antibiotic treatment with clindamycin and penicillin G was initiated and the abscess was drained. Hemodialysis with high cut-off filters was started because of acute kidney failure in the Acute Kidney Injury Network (AKIN) stage III, hemolysis and rhabdomyolysis. Therapeutic plasma exchange was performed due to sepsis and acute liver failure.

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【60岁男性患者肝脓肿致脓毒症合并溶血】。
许多产气荚膜梭菌败血症的病例被证明是致命的。我们报告一例以肝脓肿为感染焦点的产气荚膜梭菌脓毒症,通过跨学科的强化医疗管理成功治疗。这种罕见病原体的脓毒症是由于存在胆肠吻合术和预先存在的克罗恩病的免疫抑制治疗。开始用克林霉素和青霉素G进行抗生素治疗,并排出脓肿。由于急性肾损伤网络(AKIN) III期急性肾衰竭,溶血和横纹肌溶解,开始使用高截止过滤器进行血液透析。由于败血症和急性肝衰竭,进行了治疗性血浆置换。
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来源期刊
Internist
Internist 医学-医学:内科
CiteScore
1.20
自引率
0.00%
发文量
139
审稿时长
4-8 weeks
期刊介绍: Der Internist is an internationally respected journal dealing with all aspects of internal medicine. The journal serves both the scientific exchange and the continuing education of internists working in practical or clinical environments as well as of general practitioners who are particularly interested in internal medicine. The focus is on the topics of prevention, diagnostic approaches, management of complications, and current therapy strategies. Comprehensive reviews on a specific topical issue focus on providing evidenced based information on diagnostics and therapy. Case reports feature interesting cases and aim at optimizing diagnostic and therapeutic strategies. Review articles under the rubric "Continuing Medical Education" present verified results of scientific research and their integration into daily practice.
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