[Multiple organ failure in pre-term pregnancy: gestosis and/or typhoid fever?].
The authors describe a clinical case of Multiple Organ Failure (MOF). Such a pathology was reported, at admission in ICU, in a young woman aged 26 who was in the 30th week of amenorrhoea, formerly hospitalized in Obstetrics, where she had had a Caesarean section because of the met of eclamptic crisis, after a pregnancy substantially normal. At the moment of her admission to the ICU the examination highlighted the sense organ obnubilated, the breath dyspnoic, a systolic and diastolic hypotension and a tachycardia of medium seriousness. From laboratory examinations it was possible to maintain that there was a serious anemia with white cells raised, a coagulative imbalance and above all a serious alteration of hepatic and pancreatic function. The creatininemia had increased a bit, a clear contraction of diuresis was present and a considerable metabolic acidosis had become intelled. Therefore the patient was affected by multiple organ failure. In successive days it was possible to execute an EEG that proved substantially normal, then a Computer Tomography to abdomen showed the presence of vast areas of hepatic necrosis, ascitic hemorrhagic fluid and a volume increased pancreas. Hepatitis markers proved negative, while a positive response was achieved for a typhoid infection (this result was reconfirmed many times later.) Modifying the antibiotic therapy (substituting full dose ampicillin to the cephalosporin) the clinical case was solved. Moreover, also thanks to a very good answer to antibiotic therapy, it was possible to confirm the diagnosis of typhoid fever, not gestosis.
Iermano
C
C
Cattedra di Anestesia, Rianimazione e Terapia Intensiva, Facoltà de Medicina e Chirurgia, Università delgi Studi di Napoli Federico II.
Giurbino
M
M
Aloj
F
F
Servillo
G
G
Pezza
M
M
D000328:Adult; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000175:diagnosis*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D014435:Typhoid Fever / Q000175:diagnosis*
MOF in gravida pretermine: gestosi e/o febbre tifoidea?