A Case of Successful Treatment of Gram-Negative Sepsis Associated with Toxic Myelosuppression in a Patient with HIV-Associated Non-Hodgkin’s Lymphoma
This article presents a clinical case of successful treatment of gram-negative sepsis in a patient with HIV-associated non-Hodgkin’s lymphoma. The patient was admitted to the intensive care unit in critical condition after the third course of polychemotherapy according to the ICE scheme. The severit...
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| Format: | Article |
| Language: | Russian |
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Scientific Сentre for Family Health and Human Reproduction Problems
2021-04-01
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| Series: | Acta Biomedica Scientifica |
| Subjects: | |
| Online Access: | https://www.actabiomedica.ru/jour/article/view/2607 |
| _version_ | 1826853269777940480 |
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| author | D. D. Morikov V. V. Kartashova M. M. Demchenkova A. L. Khoroshikh |
| author_facet | D. D. Morikov V. V. Kartashova M. M. Demchenkova A. L. Khoroshikh |
| author_sort | D. D. Morikov |
| collection | DOAJ |
| description | This article presents a clinical case of successful treatment of gram-negative sepsis in a patient with HIV-associated non-Hodgkin’s lymphoma. The patient was admitted to the intensive care unit in critical condition after the third course of polychemotherapy according to the ICE scheme. The severity of the condition was due to nosocomial pneumonia, septic shock, multiple organ failure, immunosuppression against the background of PCT and HIV infection, and the lack of specific treatment for HIV infection. Despite the absence of a positive blood culture throughout the entire treatment period, the diagnosis of sepsis was not in doubt, according to the criteria of the 2001 International Consensus Conference on Sepsis. The cause of the septic state was the combined effect of bacteria (Pseudomonas aeruginosa) and fungi (Candida albicans, Candida krusei) against the background of persistent HIV infection. The patient’s pneumonia was destructive and was twice aggravated by spontaneous pneumothorax. At the initial stage, intensive therapy led to positive dynamics. The severity of the systemic inflammatory response decreased, the acute respiratory insufficiency regressed, the X-ray pattern improved, and laboratory parameters stabilized. Despite the continued intensive therapy in the former volume on day 19, a sharply negative dynamics was noted, which led to a re-transfer of the patient to artificial ventilation of the lungs. The replacement of antibiotics and the specific treatment of HIV infection led to the patient’s recovery. In the future, chemotherapy was not carried out. Remission of the disease lasts six years. |
| first_indexed | 2024-03-08T12:16:50Z |
| format | Article |
| id | doaj.art-45fb4171d6044e08920970420d94ae5d |
| institution | Directory Open Access Journal |
| issn | 2541-9420 2587-9596 |
| language | Russian |
| last_indexed | 2025-02-16T17:22:46Z |
| publishDate | 2021-04-01 |
| publisher | Scientific Сentre for Family Health and Human Reproduction Problems |
| record_format | Article |
| series | Acta Biomedica Scientifica |
| spelling | doaj.art-45fb4171d6044e08920970420d94ae5d2025-01-27T16:48:57ZrusScientific Сentre for Family Health and Human Reproduction ProblemsActa Biomedica Scientifica2541-94202587-95962021-04-0161263210.29413/ABS.2021-6.1.42111A Case of Successful Treatment of Gram-Negative Sepsis Associated with Toxic Myelosuppression in a Patient with HIV-Associated Non-Hodgkin’s LymphomaD. D. Morikov0V. V. Kartashova1M. M. Demchenkova2A. L. Khoroshikh3Irkutsk Regional Cancer Center; Irkutsk State Medical Academy of Postgraduate Education – Branch Campus of the Russian Medical Academy of Continuing Professional Education; Irkutsk State Medical UniversityIrkutsk Regional Cancer CenterIrkutsk Regional Cancer CenterIrkutsk Regional Cancer CenterThis article presents a clinical case of successful treatment of gram-negative sepsis in a patient with HIV-associated non-Hodgkin’s lymphoma. The patient was admitted to the intensive care unit in critical condition after the third course of polychemotherapy according to the ICE scheme. The severity of the condition was due to nosocomial pneumonia, septic shock, multiple organ failure, immunosuppression against the background of PCT and HIV infection, and the lack of specific treatment for HIV infection. Despite the absence of a positive blood culture throughout the entire treatment period, the diagnosis of sepsis was not in doubt, according to the criteria of the 2001 International Consensus Conference on Sepsis. The cause of the septic state was the combined effect of bacteria (Pseudomonas aeruginosa) and fungi (Candida albicans, Candida krusei) against the background of persistent HIV infection. The patient’s pneumonia was destructive and was twice aggravated by spontaneous pneumothorax. At the initial stage, intensive therapy led to positive dynamics. The severity of the systemic inflammatory response decreased, the acute respiratory insufficiency regressed, the X-ray pattern improved, and laboratory parameters stabilized. Despite the continued intensive therapy in the former volume on day 19, a sharply negative dynamics was noted, which led to a re-transfer of the patient to artificial ventilation of the lungs. The replacement of antibiotics and the specific treatment of HIV infection led to the patient’s recovery. In the future, chemotherapy was not carried out. Remission of the disease lasts six years.https://www.actabiomedica.ru/jour/article/view/2607hiv-associated non-hodgkin’s lymphomaseptic shocknosocomial pneumoniamyelosuppressionrenal replacement therapy |
| spellingShingle | D. D. Morikov V. V. Kartashova M. M. Demchenkova A. L. Khoroshikh A Case of Successful Treatment of Gram-Negative Sepsis Associated with Toxic Myelosuppression in a Patient with HIV-Associated Non-Hodgkin’s Lymphoma Acta Biomedica Scientifica hiv-associated non-hodgkin’s lymphoma septic shock nosocomial pneumonia myelosuppression renal replacement therapy |
| title | A Case of Successful Treatment of Gram-Negative Sepsis Associated with Toxic Myelosuppression in a Patient with HIV-Associated Non-Hodgkin’s Lymphoma |
| title_full | A Case of Successful Treatment of Gram-Negative Sepsis Associated with Toxic Myelosuppression in a Patient with HIV-Associated Non-Hodgkin’s Lymphoma |
| title_fullStr | A Case of Successful Treatment of Gram-Negative Sepsis Associated with Toxic Myelosuppression in a Patient with HIV-Associated Non-Hodgkin’s Lymphoma |
| title_full_unstemmed | A Case of Successful Treatment of Gram-Negative Sepsis Associated with Toxic Myelosuppression in a Patient with HIV-Associated Non-Hodgkin’s Lymphoma |
| title_short | A Case of Successful Treatment of Gram-Negative Sepsis Associated with Toxic Myelosuppression in a Patient with HIV-Associated Non-Hodgkin’s Lymphoma |
| title_sort | case of successful treatment of gram negative sepsis associated with toxic myelosuppression in a patient with hiv associated non hodgkin s lymphoma |
| topic | hiv-associated non-hodgkin’s lymphoma septic shock nosocomial pneumonia myelosuppression renal replacement therapy |
| url | https://www.actabiomedica.ru/jour/article/view/2607 |
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