[Respiratory failure caused by myopathy in severe sepsis].
OBJECTIVE
To describe a generalized myopathic disorder occurred in the convalescence phase of illness of a critically ill patient.


METHODS
Neurological Intensive Care Unit.


METHODS
A 43-year-old man with acute leukoencephalopathy and severe sepsis complicated by sustained and prolonged cardiovascular, respiratory and renal failure. After 15 days of complete respiratory autonomy, the patient presented an acute ventilatory failure associated with generalized muscle weakness. Neither a relapse of sepsis nor neurological worsening were detected.


RESULTS
Electromyogram resulted in normal conduction velocity in both motor and sensitive nervous fibers. Muscular biopsy showed marked fiber size variability with several hypotrophic fibers type II fiber grouping, several areas of degeneration-necrosis with macrophage invasion, dishomogeneous oxidative enzymatic activity, no increase in glycogen or lipid content.


CONCLUSIONS
These results excluded critical illness polyneuropathy and all the other known myopathies. Prolonged period of sepsis with multiple organ failure can result in a direct generalized myopathy. This possibility should be kept in mind while treating long term critically ill survivors.
Veschi
G
G
Dipartimento di Anestesia e Rianimazione, Istituto di Neurologia, IRCCS, Ospedale Maggiore, Università degli Studi, Milano.
Zanforlin
G
G
Breda
G
G
Calappi
E
E
Cigada
M
M
Colombo
A
A
Marzorati
S
S
Mulazzi
D
D
Noto
A
A
Parma
A
A
Rotelli
S
S
Prelle
A
A
Cappellari
A
A
Iapichino
G
G
D000328:Adult; D006801:Humans; D008297:Male; D009135:Muscular Diseases / Q000382:microbiology*; D012131:Respiratory Insufficiency / Q000382:microbiology*; D018805:Sepsis / Q000150:complications*; D012720:Severity of Illness Index
Insufficienza ventilatoria da miopatia in corso di sepsi severa.