Journal of Medical Academics

Register      Login

VOLUME 1 , ISSUE 1 ( January-June, 2018 ) > List of Articles

CASE REPORT

Polymicrobial Septic Shock with Multiorgan Dysfunction in an Otherwise Healthy Immunocompetent Patient

Syed A Hashmi, Lakshmi Nair, Alpana Gupta, Rajiv M Gupta

Keywords : Multiorgan dysfunction, Polymicrobial, Sepsis, Septic shock.,Atypical pneumonia

Citation Information : Hashmi SA, Nair L, Gupta A, Gupta RM. Polymicrobial Septic Shock with Multiorgan Dysfunction in an Otherwise Healthy Immunocompetent Patient. Journal of Medical Academics 2018; 1 (1):61-64.

DOI: 10.5005/jp-journals-10070-0012

License: CC BY-ND 3.0

Published Online: 00-06-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: Sepsis is a significant cause of morbidity and mortality worldwide despite advanced critical life-support. Septic shock and multiorgan dysfunction is the terminal stage in critically ill patients leading to perfusion abnormalities, lactic acidosis, oliguria and altered mental status creating a rapid downhill course and mortality. Sepsis ensues through stages of exaggerated immune response including systemic inflammatory response syndrome, in the backdrop of infectious stimuli. Case report: Polymicrobial septic shock with multiorgan dysfunction leads to demise in an otherwise healthy immunocompetent patient. Microbiological profile revealed Escherichia coli urinary tract infection (UTI), Staphylococcus sciuri bacteremia, Acinetobacter baumanii ventilator-associated pneumonia, and central line catheter tip Pseudomonas aeruginosa, thereby pointing towards polymicrobial sepsis. Neutropenia of 290/dL along with serum procalcitonin 5 ng/mL was detected. An autopsy revealed anasarca, bilateral lung abscesses, Hepatosplenomegaly, intracerebral hemorrhage, consolidated lungs, myocardial hypertrophy, and acute tubular necrosis were observed. Bacterial colonies from lungs, liver and cerebrospinal fluid grew Pseudomonas aeruginosa. Conclusion: Polymicrobial sepsis can rapidly deteriorate a patient and mandate aggressive fluid, inotrope, ventilation, and antimicrobial therapy, notwithstanding challenges in diagnosis, prognosis and optimal management


PDF Share
  1. Jindal AK, Pandya K, Khan ID. Antimicrobial Resistance: A public health challenge. Med J Armed Forces India. 2014; 71 (2): 178-181.
  2. Khan ID, Gupta RM, Sen S, Rajmohan KS, Jindal AK, Makkar A, et al. Emerging Antimicrobial Resistance and evolving healthcare: Dangerous crossroads for the community and the military. Journal of Archives in Military Medicine. In Press(In Press):e12097.
  3. Khan ID, Rajmohan KS, Jindal AK, Gupta RM, Khan S, Shukla M, Singh S, Mustafa S, Tejus A, Narayanan S. Panresistant Superbugs: Are we at the edge of a “Microbial Holocaust”. International Journal of Medicine and Medical Research. 2017; 3(2): 39-44.
  4. Hotchkiss RS, Moldawer LL, Opal SM, Reinhart K, Turnbull IR, Vincent J-L. Sepsis and septic shock. Nature reviews Disease primers. 2016;2:16045.
  5. Khan ID, Basu A, Kiran S, Trivedi S, Pandit P, Chattoraj A. Device-Associated Healthcare Associated Infections (DAHAI) and the caveat of multiresistance in a multidisciplinary Intensive Care Unit. Med J Armed Forces India. 2017; 73 (3): 222-231.
  6. Khan ID, Sahni AK, Bharadwaj R, Lall M, Jindal AK, Sashindran VK. Emerging Organisms in a Tertiary Healthcare Set Up. Med J Armed Forces India. 2014; 70 (2): 120-128.
  7. Khan ID, Sahni AK. Bacterial Infections and Emerging Resistance in Renal Transplant Recipients. Bang J Med Sci. 2015; 14 (1): 14-21.
  8. Vijayvergia V, Sahni AK, Lal M, Vijay K, Khan ID. Phenotypic detection of ESBL and Amp C Beta-Lactamases in a tertiary care hospital. Bang J Med Sci. 2013; 12 (4): 378-384. www.banglajol.info/index.php/BJMS/article/download/13309/11724.
  9. Khan ID, Lall M, Sen S, Ninawe SM, Chandola P. Multiresistant Elizabethkingia meningoseptica Infections in Tertiary Care. MJAFI 2014; 71 (3): 66-67.
  10. Khan ID, Mukherjee T, Gupta S, Haleem S, Sahni AK, Banerjee S, Konar J. Ochrobactrum anthropi sepsis in intensive tertiary care. J Basic & Clin Med 2014, 3(1): 18-20. http://sspublications.org/index.php/JBCM/article/view/35/32.
  11. Iskander KN, Osuchowski MF, Stearns-Kurosawa DJ, et al. Sepsis: Multiple Abnormalities, Heterogeneous Responses, and Evolving Understanding. Physiological Reviews.2013;93(3):1247-1288.
  12. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-810.
  13. Khan ID, Dogra PM, Ramphal SK, Khan S, Konar J, Palit A, Srivastava N, Agrawal P, Haleem S, Alam S. Polymicrobial infections in a teenaged Renal Transplant Recipient. J Basic & Clin Med 2015, 4(1): 37-39. http://sspublications.org/index. php/JBCM/article/view/41/39.
  14. Khan ID, Sahni AK, Sen S, Gupta RM, Basu A. Outbreak of prototheca wickerhamii algaemia and sepsis in a tertiary care chemotherapy oncology unit. MJAFI 2017.
  15. Reinhart K, Bauer M, Riedemann NC, Hartog CS. New Approaches to Sepsis: Molecular Diagnostics and Biomarkers. Clinical Microbiology Reviews. 2012;25(4):609-634.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.