Authors
Alpidovskaya O. V.
MD, PhD, Associate Professor, Associate Professor, Chair for General and Clinical Morphology and Forensic Medicine1
1I.N. Ulyanov Chuvash State University, Cheboksary, Russian Federation
Corresponding Author
Alpidovskaya Olga Vasilievna; e-mail: olavorobeva@mail.ru.
Funding
The study had no sponsorship.
Conflict of interest
None declared.
Abstract
Sepsis is a topical problem in medicine, especially in the course of the epidemic of a new coronavirus infection. Sepsis is based on the reaction of the body to infection in the form of generalized inflammation. The article describes a case of septic myocarditis and septicopyemia after infection with SARS-CoV-2. Description of the case. Patient S.S., born in 1976 was treated in the infectious diseases department with a diagnosis of new coronavirus infection COVID-19, severe course. Complications of the underlying disease: Bilateral interstitial pneumonia. ARDS. Sepsis. Complaints at admission: shortness of breath; heart palpitations and irregularities in the heart rhythm. He noted an increase in body temperature up to 38.2-38.50C. In connection with the deteriorating conditions, he called an ambulance and was admitted to the emergency department. Objective status: BP – 85/55 mm Hg. Heart rate – 111. Oxygen saturation – 64%. The assessment of the state on the NEWS2 scale is 11 points. Complete blood count: Leukocytes: 17.8 (3.39-8.86) 10 * 9/l, segmented neutrophils: 87% (40-68%), lymphocytes: 16% (19-37%), ESR: 69 (2-15) mm/hour. C-reactive protein (CRP): 24.5 mg/l (0-6) mg/l, Procalcitonin: 9 (0-0.064) ng/ml. CT of the chest revealed signs of bilateral viral interstitial pneumonia with a lesion area of 62%. ECG: nonspecific changes. SARS antigen – CoV-2 in swabs from the mucous membrane of the oropharynx by ICA: SARS coronavirus: detected. Despite treatment, the patient died. Sectional examination revealed signs of viral-bacterial pneumonia. In the heart – signs of acute heart failure; diffuse cellular infiltrates in the myocardium. In the spleen – plethora and leukocytosis of the red pulp. Conclusion: the patient had changes in the lungs in the form of viral-bacterial pneumonia and signs of septicopyemia with septic myocarditis and acute heart failure.
Key words
COVID-19, viral-bacterial pneumonia, sepsis, septicopyemia, septic myocarditis, septic spleen
DOI
References
1. Khirmanov V.N. COVID-19 kak sistemnoe zabolevanie. [COVID-19 as a systemic disease.] Klinicheskaya farmakologiya i terapiya [Clinical pharmacology and therapy] 2021; (1): 5-15, doi: 10.32756/0869-5490-2021-1-5-15 (In Russ.)
2. Picchianti Diamanti A., Rosado M.M., Pioli C. et al. Cytokine Release Syndrome in COVID-19 Patients, A New Scenario for an Old Concern: The Fragile Balance between Infections and Autoimmunity. Int J Mol Sci. 2020; 21(9): 3330, doi: 10.3390/ijms21093330
3. Ehrenfeld M., Tincani A., Andreoli L. et al. COVID-19 and autoimmunity. Autoimmun Rev. 2020; 102597, doi: 10.1016/j.autrev.2020.102597
4. Singer M., Deutschman C.S., Seymour C.W., et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016; 315: 801-810, doi: 10.1001/jama.2016.0287
5. Shchegolev A.I., Tumanova U.N., Mishnev O.D. Patologiya serdca pri sepsise. [Pathology of the heart in sepsis.] Mezhdunarodnyj zhurnal prikladnyh i fundamental'nyh issledovanij [International Journal of Applied and Basic Research] 2019; (9): 56-61.
6. Vorobieva O.V. Izmeneniya v organah pri inficirovanii COVID-19 s razvitiem septikopiemii. [Changes in organs during infection with COVID-19 with the development of septicopyemia.] Profilakticheskaya medicina [Preventive medicine] 2021; 24(10): 89‑93, doi: 10.17116/profmed20212410189 (In Russ.)
7. Vorobieva O.V., Romanova L.P. Ishemicheskij insul't golovnogo mozga i ostraya serdechnaya nedostatochnost' u bol'nyh saharnym diabetom posle inficirovaniya SARS-CoV-2. [Ischemic cerebral stroke and acute heart failure in diabetic patients after SARS-CoV-2 infection.] Profilakticheskaya medicina [Preventive medicine] 2022; 25(2): 61‑65, doi: 10.17116/profmed20222502161 (In Russ.)
8. Khatsko V.V., Potapov V.V., Zenin O.K. Etiologiya, patogenez i diagnostika sepsisa (obzor literatury). [Etiology, pathogenesis and diagnosis of sepsis (literature review).] Izvestiya vuzov. Povolzhskij region. Medicinskie nauki [News of Higher Education Institutions. Volga region. Medical Sciences] 2017; No. 3 (43). (In Russ.)
9. Zarubin E.A., Kogan E.A. Patogenez i morfologicheskie izmeneniya v legkih pri COVID-19. [Pathogenesis and morphological changes in the lungs with COVID-19.] Arhiv patologii [Archive of pathology] 2021;83(6):54 59. (In Russ.)