title: When sepsis affects the heart: A case report and literature review.
abstract: A 59-year-old nursing home patient with Down syndrome was brought to the internal medicine department of our hospital due to fever, cough without expectorate, and dyspnea. A thoracic computed tomography revealed the presence of bilateral basal parenchymal opacities. Her condition deteriorated after admission and troponin reached a peak serum concentration of 16.9 ng/mL. The patient was in cardiogenic shock. In addition to fluid resuscitation, vaso-active amine infusion was administered to achieve hemodynamic stabilization. The differential diagnosis investigated possible pulmonary embolism, myocardial infarction, and myocarditis. Furthermore, a second transthoracic echocardiogram suggested Tako-Tsubo syndrome. This is a septic patient. The purpose of this manuscript is to review studies which formerly examined the possible association between high levels of troponin and mortality to see if it can be considered a positive predictive factor of fatal prognosis as the case of thrombocytopenia, already a positive independent predictive factor of multiple organ failure syndrome, and generally to characterize risk profile in a septic patient.
authors: Giuseppe Clemente, Antonino Tuttolomondo, Daniela Colomba, Rosaria Pecoraro, Chiara Renda, Vittoriano Della Corte, Carlo Maida, Irene Simonetta, Antonio Pinto, U.O.C. di Medicina Interna e Cardioangiologia, University of Palermo, 90127 Palermo, Italy.
authors: Giuseppe
authors: G
authors: Clemente
authors: Giuseppe Clemente, Antonino Tuttolomondo, Daniela Colomba, Rosaria Pecoraro, Chiara Renda, Vittoriano Della Corte, Carlo Maida, Irene Simonetta, Antonio Pinto, U.O.C. di Medicina Interna e Cardioangiologia, University of Palermo, 90127 Palermo, Italy.
authors: Antonino
authors: A
authors: Tuttolomondo
authors: Giuseppe Clemente, Antonino Tuttolomondo, Daniela Colomba, Rosaria Pecoraro, Chiara Renda, Vittoriano Della Corte, Carlo Maida, Irene Simonetta, Antonio Pinto, U.O.C. di Medicina Interna e Cardioangiologia, University of Palermo, 90127 Palermo, Italy.
authors: Daniela
authors: D
authors: Colomba
authors: Giuseppe Clemente, Antonino Tuttolomondo, Daniela Colomba, Rosaria Pecoraro, Chiara Renda, Vittoriano Della Corte, Carlo Maida, Irene Simonetta, Antonio Pinto, U.O.C. di Medicina Interna e Cardioangiologia, University of Palermo, 90127 Palermo, Italy.
authors: Rosaria
authors: R
authors: Pecoraro
authors: Giuseppe Clemente, Antonino Tuttolomondo, Daniela Colomba, Rosaria Pecoraro, Chiara Renda, Vittoriano Della Corte, Carlo Maida, Irene Simonetta, Antonio Pinto, U.O.C. di Medicina Interna e Cardioangiologia, University of Palermo, 90127 Palermo, Italy.
authors: Chiara
authors: C
authors: Renda
authors: Giuseppe Clemente, Antonino Tuttolomondo, Daniela Colomba, Rosaria Pecoraro, Chiara Renda, Vittoriano Della Corte, Carlo Maida, Irene Simonetta, Antonio Pinto, U.O.C. di Medicina Interna e Cardioangiologia, University of Palermo, 90127 Palermo, Italy.
authors: Vittoriano
authors: V
authors: Della Corte
authors: Giuseppe Clemente, Antonino Tuttolomondo, Daniela Colomba, Rosaria Pecoraro, Chiara Renda, Vittoriano Della Corte, Carlo Maida, Irene Simonetta, Antonio Pinto, U.O.C. di Medicina Interna e Cardioangiologia, University of Palermo, 90127 Palermo, Italy.
authors: Carlo
authors: C
authors: Maida
authors: Giuseppe Clemente, Antonino Tuttolomondo, Daniela Colomba, Rosaria Pecoraro, Chiara Renda, Vittoriano Della Corte, Carlo Maida, Irene Simonetta, Antonio Pinto, U.O.C. di Medicina Interna e Cardioangiologia, University of Palermo, 90127 Palermo, Italy.
authors: Irene
authors: I
authors: Simonetta
authors: Giuseppe Clemente, Antonino Tuttolomondo, Daniela Colomba, Rosaria Pecoraro, Chiara Renda, Vittoriano Della Corte, Carlo Maida, Irene Simonetta, Antonio Pinto, U.O.C. di Medicina Interna e Cardioangiologia, University of Palermo, 90127 Palermo, Italy.
authors: Antonio
authors: A
authors: Pinto
keywords: Hypotension; Myocardial dysfunction; Sepsis; Shock; Troponin