A successful management after preterm delivery in a patient with severe sepsis during third-trimester pregnancy / 영남의대학술지
Yeungnam University Journal of Medicine
;
: 84-88, 2018.
Artículo
en Inglés
| WPRIM
| ID: wpr-787090
ABSTRACT
A 33-year-old woman visited the emergency department presenting with fever and dyspnea. She was pregnant with gestational age of 31 weeks and 6 days. She had dysuria for 7 days, and fever and dyspnea for 1 day. The vital signs were as follows blood pressure 110/70 mmHg, heart rate 118 beats/minute, respiratory rate 28/minute, body temperature 38.7℃, and oxygen saturation by pulse oximetry 84% during inhalation of 5 liters of oxygen by nasal prongs. Crackles were heard over both lung fields. There were no signs of uterine contractions. Chest X-ray and chest computed tomography scan showed multiple consolidations and air bronchograms in both lungs. According to urinalysis, there was pyuria and microscopic hematuria. She was diagnosed with community-acquired pneumonia and urinary tract infection (UTI) that progressed to severe sepsis and acute respiratory failure. We found extended-spectrum beta-lactamase producing Escherichia coli in the blood culture and methicillin-resistant Staphylococcus aureus in the sputum culture. The patient was transferred to the intensive care unit with administration of antibiotics and supplementation of high-flow oxygen. On hospital day 2, hypoxemia was aggravated. She underwent endotracheal intubation and mechanical ventilation. After 3 hours, fetal distress was suspected. Under 100% fraction of inspired oxygen, her oxygen partial pressure was 87 mmHg in the arterial blood. She developed acute kidney injury and thrombocytopenia. We diagnosed her with multi-organ failure due to severe sepsis. After an emergent cesarean section, pneumonia, UTI, and other organ failures gradually recovered. The patient and baby were discharged soon thereafter.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Oxígeno
/
Presión Parcial
/
Neumonía
/
Complicaciones Infecciosas del Embarazo
/
Piuria
/
Respiración Artificial
/
Insuficiencia Respiratoria
/
Esputo
/
Tórax
/
Trombocitopenia
Límite:
Adulto
/
Femenino
/
Humanos
/
Embarazo
Idioma:
Inglés
Revista:
Yeungnam University Journal of Medicine
Año:
2018
Tipo del documento:
Artículo
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