Author/Editor		Kirbiš, Simona; Marinšek, Martin
Title		Prikaz primera dveh bolnikov s sepso zaradi izven bolnišnične okužbe
Type		članek
Source		In: Hojs R, Krajnc I, Pahor A, et al, editors. Zbornik predavanj in praktikum 19. srečanje internistov in zdravnikov splošne medicine "Iz prakse za prakso"; 2008 maj 30-31; Maribor. Maribor: Univerzitetni klinični center,
Publication year		2008
Volume		str. 247-2
Language		slo
Abstract		We present two patients with community acquired pneumonia and developing septic shock that were treated in the Intensive Care Unit at the University Clinical Center Maribor. The first patient was young smoker admitted with fatigue, dyspnea, vertigo, without fever, with leucopenia, thrombocytopenia and elevated inflommotory markers. His clinical picture progressed rapidly to septic shock. The patient needed temporary inotropic support. Streptococcus pneumonioe was recovered from blood cultures and trochea aspirate. With intensive care and timely antibiotic therapy he made a full recovery. The second patient was an elderly man with chronic obstructive lung disease, heart failure and was admitted unconscious, with fever and developing septic shock. The patient needed inotropic support and mechanical ventilation. Streptococcus pneumonioe was recovered from blood cultures and trachea aspirate. Despite intensive care and timely antibiotic therapy he developed multi organ failure and died.
Summary		Za ponazoritev sepse, ki je posledica zunajbolnišnične pljučnice povzročene s Streptococcus pneumoniae, smo izbrali dva primera bolnikov, ki smo ju zdravili na Oddelku za intenzivno interno medicino Univerzitetnega kliničnega centra Maribor. Pri prvem bolniku, ki je zbolel nenadno s težkim dihanjem, splošnim slabim počutjem in omotico, brez povišane telesne temperature, z levkopenijo in trombocitopenijo ter visokimi vnetnimi parametri, se je razvil septični šok. Potreboval je vazopresorno zdravljenje z noradrenalinom in dopaminom ter kisik. Iz aspirata traheje in hemokultur je bil izoliran Streptococcus pneumoniae. Ob intenzivnem zdravljenju in ustrezni in pravočasni antibiotični terapiji se je bolnikovo stanje popolnoma popravilo. Drugi bolnik s kronično obstruktivno pljučno boleznijo in srčnim popuščanjem je bil sprejet nezavesten, visoko febrilen, z razvijajočim se septičnim šokom. Potrebna je bila intubacija in mehanično predihovanje z visokim odstotkom kisika ter vazopresorna podpora z noradrenalinom in dopaminom. Iz hemokultur in aspirata traheje je bil izoliran pnevmokok. Kljub intenzivnemu zdravljenju in ustrezni in pravočasni antibiotični terapiji je prišlo do več organske odpovedi in bolnik je umrl.
Descriptors		STREPTOCOCCUS PNEUMONIAE STREPTOCOCCUS PNEUMONIAE PNEUMONIA SEPSIS