*For medical professionals for reference
Do not ignore the history of epidemiological diseases
Written article | Panda
This is a case published on BMJ Case Reports [1].However, the rapid development of the condition exceeded everyones imagination, and died on the third day of admission due to acute liver failure complications. What is going on? We then look down!
I was admitted to the hospital for 2 days,
No other obvious abnormalities were seen
Aunt Li (pseudonym) at the age of 81, female, previous The history of this disease was performed in thyroid thyroid division in 2017.Decarn the history of steroids, immunosurative agents or traditional drugs/supplements, deny the history of drinking of alcohol, the history of intravenous injection entertainment drugs or the history of previous tattoos, and deny the history of liver disease.
This time Aunt Li was admitted to the hospital because of upper abdominal pain for 2 days , accompanied by nausea, vomiting once, the content of the stomach, fearless chills, cough and sputum,Diarrhea and abdominal distension and other special discomforts, the signs of life are stable.The inspection showed the upper abdomen tenderness. No , the rash, there was no obvious abnormality in the surplus grid examination.
Subsequently improve the laboratory inspection and only indicate that mild thrombocytopenia (136 × 109/L) and mild liver damage (Alanine transaminase 58U/L, and winter aminotransin 141U/L).At the same time, the electrocardiogram on the day of admission was not obvious. The CT scan showed that the size of the gallbladder was about 0.3cm stones, and there was no abnormality.
Blossom rash,
The tremendous disease worsen
However, on the second day of admission (on the third day of the onset), Aunt Li continued to abdominal pain and could not bear it.Rise of emergency drama (Alanine transaminase 380U/L, 天 冬 1105U/L), Pattipable painless blisters rash on the back of the patient, then developed to the neck in the early morning of the next day to the neck the next morning to the neck the next morning to the neck the next morning to the neck the next morning to the neck the next morning to the neck the next morning to the neck the next morning to the neck the next morning to the neck the next morningMinistry and front torso .
Just then, Aunt Lis family suddenly thought that Aunt Lis partner was infected a week ago ...
Will it be because of close contact with infection with related infectious diseases?The doctor immediately conducted a relevant inspection and experience treatment of Aunt Li. However, on the third day of admission, Aunt Lis condition worsened.At noon on the same day (about 52 hours after the clinic), Aunt Li appeared outbreak of liver failure , and the review of the relevant indicators indicated that the liver loss rose sharply (Table 1).Unfortunately, despite active support treatment, Aunt Li died due to multiple organ failure.
Table 1
Thinking
1. Do you know what Aunt Li was infected?
2. Why does Aunt Li have upstate liver failure?
3. How to diagnose and treat tragedy early?
References :
[1] fang c, wong j, ang ww.fulminant varicela hepatitis:a rare but Lethal cause of Abdominal Pain.bmj Case Rep.2021 SEP 3; 14 (9): E244081.doi: 10.1136/BCR-2021-244081.pmid: 34479894; .
[2] Furuto y, kawamura m, namikawa a, et al.Successful Management of Visceral Disseminated Varicella Zoster Virus Atment of membranous nephropathy: a case report.bmc infect design; 19: 625
[3] Lechiche C, Le Moing V, François Perrigault P, Et Al.Fulminant Varicella Hepatitis in A Human ImmunodeFicience Virus Infection P Atient: Case Report and Review of the Literateure.scandJ infect dis 2006; 38: 929–31.
[4] Saitoh H, Takahashi N, Nanjo H, et al.Varicella-Zoster virus-associa owing allogeneic hematopoietic sTemCell Transplantation for Multiple MyLoma.intern Med 2013; 52: 1727–30.
[5] Ross js, Fanning WL, Beautyman W, et al.Fatal massive hepatic Rosis from varicella-Zoster hepatitis.am j gastrointerol 1980; 74: 423–7.
[6] Maggi U, Russo R, Conte G, et al.Fulminant Multiorgan Zoster Virus andHhv6 in an immunocompetent adult patient, and anhepatia.transplant proc 2011; 43: 1184 –6
Source of this article: The medical community infection channel
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