ABSTRACT
We report two cases of septic shocks due to Salmonella non typhi infection on sickle cell patients admitted to an intensive care unit. Such patients should enforce food hygiene measures, especially under tropical settings, to avoid potentially deadly severe infections.
Subject(s)
Anemia, Sickle Cell/complications , Salmonella Infections/complications , Salmonella enteritidis/isolation & purification , Salmonella typhimurium/isolation & purification , Shock, Septic/etiology , Adolescent , Anemia, Sickle Cell/epidemiology , Cholecystectomy , Cholecystitis/complications , Cholecystitis/surgery , Clostridium Infections/complications , Combined Modality Therapy , Comorbidity , Critical Care/methods , Cytomegalovirus Infections/complications , Disease Susceptibility , Female , Humans , Intensive Care Units , Male , Osteomyelitis/etiology , Postoperative Complications/microbiology , Reunion/epidemiology , Salmonella Food Poisoning/prevention & control , Salmonella Infections/epidemiology , Salmonella Infections/microbiology , Salmonella Infections/prevention & control , Shock, Septic/epidemiology , Shock, Septic/microbiology , Shock, Septic/therapy , Subarachnoid Hemorrhage/etiology , Young Adult , beta-Thalassemia/complicationsABSTRACT
In the Southern hemisphere, Réunion Island acts as a sentinel for infections preferentially occurring during the austral winter that are likely to reach the Northern hemisphere a few months later. We relate the main features concerning patients that were admitted during years 2009 and 2010 in our intensive care unit with an A(H1N1)v2009 infection, mainly for acute respiratory distress. Demographic, clinical, and biological data as well as given medications and outcome were prospectively collected among all PCR-confirmed influenza-infected patients. In 2009 and 2010, 25 patients met the criteria. Patients' median age was 40.4 (±17.4) years. Most of them (22/25) had comorbidities such as: chronic diseases, overweight, obesity, pregnancy, and Down syndrome. Maximum bed-occupation rate was 10 days per million inhabitants. Main diagnosis for ICU admission was virus-related pneumonia. Twenty-two out of 25 patients needed mechanical ventilation, some required rescue therapies such as extracorporeal membranous oxygenation (ECMO) or hi-frequency oscillation ventilation (HFOV), both only available in few French hospitals. Within the study period, 12 patients died (48%) mainly of multi-organ failure. Through 2009 and 2010 autumn and winter periods, for several weeks, the A(H1N1)v2009 virus infection resulted in a significant increase of workload in Réunion Island ICUs. In 2010, the failure of the mass immunization campaign, particularly among the at-risk groups, led to severe cases of A(H1N1)v2009 infections, particularly among patients with comorbidities. Our data may contribute toward better management of influenza virus pandemics in the future.
