Severe acute myocardial infarction during a staphylococcal septicemia with meningoencephalitis. A possible contraindication to thrombolytic treatment.
We report the first case of lethal intracranial haemorrhage complicating a treatment by rt-PA in a patient presenting with a simultaneous staphylococcal septicemia with meningoencephalitis and an acute myocardial infarction with cardiogenic shock. The presence of microvascular lesions in the central nervous system seems to be important risk factor for intracranial haemorrhage and we recommend extreme caution in the use of thrombolytic treatment in septicemic patients with acute myocardial infarction, particularly when neurological symptoms are present.
Reynard
C A
CA
Cardiology Center, Geneva University Hospital, Switzerland.
Calain
P
P
Pizzolato
G P
GP
Chevrolet
J C
JC
D002543:Cerebral Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D008590:Meningoencephalitis / Q000150:complications*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D012307:Risk Factors; D018805:Sepsis / Q000150:complications*; D013203:Staphylococcal Infections / Q000150:complications*; D010959:Tissue Plasminogen Activator / Q000009:adverse effects*
D006493:Heparin; D010959:Tissue Plasminogen Activator