Venoarterial extracorporeal membrane oxygenation for septic cardiomyopathy caused by Pasteurella multocida infection: a case report
Venoarterial extracorporeal membrane oxygenation for septic cardiomyopathy caused by Pasteurella multocida infection: a case report
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静脉-动脉体外膜氧合治疗多杀性巴氏杆菌感染所致脓毒症心肌病一例报告
DOI：
10.1007/s00540-022-03057-4
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发表时间：
2022
影响因子：
2.8
通讯作者：
Arai Masayasu
中科院分区：
文献类型：
--
作者：
Nagai Ai;Adachi Takeshi;Nishizawa Yoshiyuki;Kuroiwa Masayuki;Arai Masayasu
巴氏杆菌是一种革兰氏阴性球杆菌，通常通过猫和狗咬伤传播，并导致人类多种疾病。在目前的情况下，亲吻一只动物会导致巴氏杆菌感染，导致败血症和心源性休克。我们使用静脉动脉体外膜肺氧合（VA-ECMO）来支持心血管系统，直到恢复。一名62岁男性，无相关病史，因咽喉痛和发热1天而被转诊至我院。他被诊断为颈部蜂窝织炎，后来出现败血性休克，需要给予儿茶酚胺和插管。随后发现患者患有巴氏杆菌性无菌血症，并在家中饲养宠物犬。除败血症外，患者还发生难治性心源性休克，对药物治疗无反应;因此，开始VA-ECMO。引入后，患者的血流动力学状态改善，6天后脱离体外循环。50天后，他出院回家，恢复了以前的生活。巴氏杆菌感染可导致健康成人脓毒症，随后发生严重的心功能障碍。因此，VA-ECMO可能是脓毒症引起的心肌功能不全和难治性心源性休克患者的一种有用的治疗选择。
Pasteurellais a gram-negative coccobacillus that is commonly transmitted through cat and dog bites and causes various diseases in humans. In the present case, kissing an animal causedPasteurella multocidainfection, leading to sepsis and cardiogenic shock. We used venoarterial extracorporeal membrane oxygenation (VA-ECMO) to support the cardiovascular system until recovery. A 62-year-old man with no relevant history was referred to our hospital with a 1-day history of sore throat and fever. He was diagnosed with cervical cellulitis and later developed septic shock, which necessitated catecholamine administration and intubation. It was subsequently revealed that the patient hadPasteurella multocidabacteremia and kept a pet dog at home. In addition to sepsis, the patient experienced refractory cardiogenic shock and was unresponsive to medical treatment; therefore, VA-ECMO was initiated. After its introduction, the patient’s hemodynamic status improved, and he was weaned from extracorporeal circulation after 6 days. He was discharged home and resumed his former life 50 days later.Pasteurella multocidainfection can cause sepsis followed by severe cardiac dysfunction in healthy adults. Therefore, VA-ECMO may be a useful treatment option in patients with sepsis-induced myocardial dysfunction and refractory cardiogenic shock.