Only had a fever for 2 days, but as soon as he entered the hospital, the patient went into septic shock, multi-organ failure, respiratory failure, heart failure, and kidney failure. At the same time, the patient responded very poorly to initial aggressive treatment measures, and the infection continued to progress throughout the body.
Recently, the Department of Emergency Medicine and Intensive Care – Hanoi Medical University Hospital received a 38-year-old male patient, a teacher at a highland primary school in Son La, admitted to the hospital due to fever on Monday. accompanied by joint pain on both sides and great fatigue.
The disease progressed very quickly, with only a fever for 2 days, but as soon as he was admitted to the hospital, the patient went into septic shock, multi-organ failure, respiratory failure, heart failure, and kidney failure. The patient was quickly and actively resuscitated with many optimal measures including fluid infusion, strong antibiotics, mechanical ventilation, and continuous dialysis.
However, the patient responded very poorly to initial aggressive treatment measures, and the infection continued to progress throughout the body. Worse news for the treating doctors was that the patient’s blood culture showed the Burkholderia pseudomallei bacteria that causes Whitmore’s disease.
According to medical literature, cases of Burkholderia pseudomallei infection with septic shock have an extremely high mortality rate. The bacteria will spread throughout the body, forming many whole-body abscesses that respond very poorly to antibiotics.
The patient continued to have more severe shock and respiratory failure that did not respond to mechanical ventilation. In addition to the abscesses throughout the body, thrombosis began to form in the lower limbs and pulmonary arteries, accompanied by the patient suffering from hemorrhagic shock due to bleeding. blood from the stomach.
Clinical indicators and prognostic scales in the literature show a mortality rate of almost 100%. The situation is even more difficult when the patient is a poor teacher in a highland area, the patient’s father has just passed away from cancer, and daily resuscitation costs can reach tens of millions of dong.
In a situation where the patient’s hope for survival was very fragile, a hospital-wide consultation was held under the chairmanship of Associate Professor Dao Xuan Thanh – Deputy Director of the hospital, and Associate Professor Hoang Bui Hai – Head of the Department of Emergency Medicine and Rehabilitation. positive energy, and doctors in many specialties of the hospital.
Under the professional guidance of hospital leaders and department leaders, along with the contribution of the Social Work Department to call for financial support (more than 100 million VND) to benefactors, the doctors were confident. more and more determined to treat patients.
The antibiotic regimen was adjusted, the cardiopulmonary bypass technique VV-ECMO was deployed, while running ECMO, thrombosis was treated with anticoagulants, the patient had severe coagulation disorders, hemorrhagic shock due to stomach bleeding. many times thick. There were times when I had to perform endoscopic hemostasis in the middle of the night and transfuse many liters of blood products. It seemed like the patient couldn’t make it.
However, everyone did not give up. With the experience of successfully resuscitating many seriously ill patients for months, the doctors still hoped that the opportunity would come to the poor teacher to continue to bring the letters come to children in the highlands.