Shock séptico en paciente con alteración del estado cognitivo

Abstract

In the present work it is described the case of a 34-year-old female patient, indigenous race with a history of altered cognitive status of 60% assessed according to the criteria of the Ministry of Public Health (CONADIS), epilepsy and sequelae of right-sided hemiparesis. That person presented cough with expectoration of 2 days of evolution, distal cyanosis and other symptoms associated with respiratory insuffiency, in addition to hypotension and tendency to drowsiness. The paraclinics showed neutropenia, thrombocytopenia and respiratory acidosis, the standard chest X-ray of her admission showed left basal infiltrates and pleural effusion, later she presented hypotension that did not respond to volume loads plus a Qsofa score of 3, thus it is classified as a septic shock. pulmonary focus, then admittance to the intensive care unit for ventilatory and hemodynamic support is admitted. Through the administration of broad-spectrum antibiotic therapy, the patient showed gradual improvement, but she developed several complications until achieving stability and being able to leave the intensive care unit for hospitalization and then be discharged. The mentioned table was presented by the patient 3 times in a period of 7 months, in which she entered the intensive care unit with similar morbidity characteristics compatible with shock characterized by great decompensation and admission to intensive therapy. It was analyzed her last episode and the complications that developed during the course of the event until her sudden death within a few days of the last outpatient visit.