[39-Year-Old Woman with Severe COVID-19 Pneumonia: Successful Weaning after Septic Shock and Forefoot Amputation after Microvascular Complications]. / 39-jährige Frau mit schwerer COVID-19-Pneumonie: Erfolgreiches Weaning nach septischem Schock und Vorfußamputation wegen mikrovaskulärer Komplikationen.
Pneumologie
; 75(7): 526-530, 2021 Jul.
Article
in German
| MEDLINE | ID: covidwho-1192607
ABSTRACT
We present the case of a slightly obese 39-year-old patient with a severe course of COVID-19 pneumonia. The patient was referred from a hospital to regular care with suspected COVID-19 pneumonia. The initial clinical symptoms consisted of dysuria and fever. A bilateral infiltrate was seen in the chest x-ray. In the CT thorax, advanced COVID-19 typical changes were found on both sides. The COVID-19 infection was confirmed by a positive SARS-CoV-2 PCR from the nasopharynx smear. In the case of progressive ARDS with respiratory exhaustion, the patient was intubated and invasively ventilated. When a bacterial superinfection was suspected, we initiated empirical antibiotic therapy. In addition, a therapy with dexamethasone was applied. Therapy with ASA and weight-adapted semi-therapeutic low molecular weight heparin was also carried out. During the intensive care treatment the patient developed a fulminant septic shock with consecutive severe thrombocytopenia. A dilated tracheotomy was performed. The weaning progress was hampered by recurrent septic attacks. Necrosis in the area of ââthe right foot was identified as the cause of the septic relapses. As there was no alternative focus, surgical rehabilitation with partial amputation was carried out. The patient then remained infection-free and could be weaned from the respirator.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Shock, Septic
/
COVID-19
Type of study:
Case report
/
Diagnostic study
/
Prognostic study
Limits:
Adult
/
Female
/
Humans
Language:
German
Journal:
Pneumologie
Year:
2021
Document Type:
Article
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