A Case of Septic Shock of Unknown Origin Guidelines for Management of Sepsis
Department of Emergency and Critical Care Medicine, Nippon Medical School
A 75-year-old man with histories of myocardial infarction, cerebellar infarction and benign prostatic hyperplasia was transferred to our critical care center because of progressive dyspnea and disturbance of consciousness. He was intubated for the treatment of hypoxemia under 10 L/min oxygen inhalation with a mask-reservoir bag device. He showed septic shock, and initially we treated him as a case of sepsis due to pneumonia, as indicated by a chest X-ray. But his condition worsened despite the treatment for severe sepsis, which was carried out in accordance with guidelines published in 20041. We performed a systemic examination by CT scan and found slight hydronephrosis due to incompletely incarcerated urolithiasis at the second hospital day. We diagnosed pyelonephritis, performed nephrostomy and drained pyuria. Subsequently he became hemodynamically stable and was transferred to another hospital for rehabilitation.
úãåãï 2005; 1(3), 135-139
severe sepsis, guideline, pyelonephritis
Shin-ichiro Shiraishi, Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan