Author/Editor		Kariž, Stojan; Kramar, Irena; Marušič, Tamara
Title		Masivna znotrajžilna hemoliza pri bolnici z ulceroznim kolitisom in sepso, povzročeno s Klebsiello pneumoniae
Translated title		Masive intravascular hemolysis in a patient with ulcerative colitis and Klebsiella pneumoniae sepsis
Type		članek
Source		In: Bručan A, Gričar M, Vajd R, editors. Urgentna medicina: izbrana poglavja. Zbornik 11. mednarodni simpozij o urgentni medicini; 2004 jun 9-12; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year		2004
Volume		str. 304-7
Language		slo
Abstract		Introduction. Massive intravascular hemolysis is a devastating and often fatal disease event. Case. A 62-year old female patient with ulcerative colitis was hospitalized because of general deterioration with fever and sideropenic anemia. Blood tests revealed neutropenia, which was assigned as a possible complication of mesalazine treatment. Because of high probability of bacterial infection with sepsis she received combined intravenous antibiotic therapy with ciprofloxacin and metronidazol, to which ceftazidime and garamycin were later added. She received also a transfusion of 2 units of packed red blood cells. On the following day she developed massive intravascular hemolysis with rapidly deteriorating shock and multiple organ failure. She died 31 hours after admission to the hospital. Blood cultures obtained before antibiotic therapy were positive for Klebsiella pneumoniae. Conclusions. Despite extensive diagnostic workout we couldn't explain the exact cause of massive intravascular hemolysis. We suppose that fatal complication was due to fulminant Klebsiella pneumoniae sepsis as a consequence of depressed immune response due to ulcerative colitis and neutropenia.
Descriptors		COLITIS, ULCERATIVE SEPSIS KLEBSIELLA PNEUMONIAE HEMOLYSIS MIDDLE AGE FATAL OUTCOME