Author/Editor		Bedernjak-Bajuk, Nataša
Title		Zaporeden potek okužb z različnimi povzročitelji pri 76-letni bolnici
Translated title		Successive infection with different agents in 76-years old patient
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 72, št. 2
Publication year		2003
Volume		str. 63-6
Language		slo
Abstract		Background. A case comprising six successive infections in period lasting from September 12, 1999 to November 23, 1999 in 76 years old female is presented. The etiological agents were confirmed in/with the firstfour infections but with the last two the purulent meningitis and septic shock infection, blood and liquor cultures were negative. We presume that this was caused by antibiotic therapy before her second admission in the hospital and because of intensive antibiotic therapy of purulent meningitis. The first five infections were successfully treated: enteritis caused by Clostridium difficile, sepsis caused by Salmonella enteritidis, candidiasis that appeared during the therapy of both sepsis, Campylobacter jejuni infection and purulent meningitis. The number of leukocytes and granulocytes fell under the normal values in all infections and during the recovery their increase could be observed. The patient died in septic shock, with acute renal failure, with bleedings in the lung in the skin, in the urinary tract and in the brain. Conclusions. The leukopenia and the granulocytopenia are themselves the signs of serious infections. They accelerate the appearance of new infections and they reduce the success of therapy. The expected mortality total rate for this six infections is very high. The massive bleedings in the brain are lethal.
Summary		Izhodišča. Prikazujemo šest zaporednih okužb pri 76-letni bolnici v času od 12. 9. 1999 do 23. 11. 1999. Pri prvih štirih smo dokazali povzročitelje, pri gnojnem meningitisu in pri zadnji okužbi, ki ji je sledil septični šok, pa so bile hemokulture in likvorske kulture negativne. Menimo, da je bil vzrok za neuspešno osamitev povzročiteljev antibiotično zdravljenje doma pred ponovnim sprejemom v bolnišnico, pri septičnem šoku pa intenzivno zdravljenje gnojnega meningitisa. Prvih pet okužb smo uspešno pozdravili: enterokolitis, ki ga je povzročil Clostridium difficile, sepso, ki jo je povzročila Salmonella enteritidis, kandidiazo, ki se je pojavila med zdravljenjem dvakrat, okužbo s Campylobacterjem jejuni in gnojni meningitis. Ob okužbah se je znižalo število levkocitov in granulocitov pod normalne vrednosti, ko se je zdravstveno stanje izboljšalo, pa se je število zviševalo. Bolnica je umrla zaradi septičnega šoka, z akutno ledvično odpovedjo, s krvavitvami v pljuča, kožo, sečila in možgane. Zaključki. Levkopenija in granulocitopenija sta znamenje hudega poteka okužbe. Poslabšata možnosti za uspešnost zdravljenja in povečata možnost, da se pojavijo nove okužbe. Pričakovana skupna smrtnost za vseh šest okužb je zelo visoka. Obsežne krvavitve v možgane so smrtne.
Descriptors		SEPSIS SHOCK, SEPTIC CLOSTRIDIUM DIFFICILE SALMONELLA ENTERITIDIS CANDIDIASIS AGED CAMPYLOBACTER JEJUNI MENINGITIS, BACTERIAL