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Zhang Y, Hu H, Xu Y, Chen Y, Liu B, Chen J, Nie W, Zhong S, Ma J, Liu C. Venous-arterial extracorporeal membrane oxygenation for psittacosis pneumonia complicated with cardiogenic shock: case report and literature review. BMC Cardiovasc Disord 2024; 24:6. [PMID: 38166547 PMCID: PMC10763678 DOI: 10.1186/s12872-023-03669-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/11/2023] [Indexed: 01/04/2024] Open
Abstract
INTRODUCTION Dilated cardiomyopathy (DCM) is characterized by the enlargement of the left ventricle or biventricular, accompanied by myocardial systolic dysfunction. Chlamydia psittacosis (CP) is a zoonotic pathogen, which can cause severe pneumonia, respiratory failure, and acute organ dysfunction. The deterioration of DCM caused by CP infection is extremely rare, and few cases of successful management were reported. CASE PRESENTATION We reported a 67-year-old male patient with DCM and chronic heart failure. Who was admitted to ICU with severe pneumonia, acute hypoxemic respiratory failure, acute decompensated heart failure, arrhythmia, and cardiogenic shock. Mechanical ventilation (MV) and venous-arterial extracorporeal membrane oxygenation (VA-ECMO) were established for respiratory and circulatory support. Broncho alveolar lavage fluid(BALF)was collected for culture and metagenomics next-generation sequencing (mNGS) test. Repeated mNGS tests indicated the high possibility of CP pneumonia, thereafter, moxifloxacin and doxycycline were prescribed. After targeted antibiotics and organ support treatment, pneumonia, respiratory and circulatory failure were gradually resolved, patient was successfully weaned from MV and VA-ECMO. Finally, the patient was recovered and discharged alive. CONCLUSIONS Severe respiratory and circulatory failure caused by CP infection in DCM patients is a rare life-threatening clinical condition. Early accurate diagnosis, targeted antibiotic therapy, coupled with extracorporeal life support posed positive impact on the patient's disease course and outcome.
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Affiliation(s)
- Yanting Zhang
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Hongtao Hu
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Ying Xu
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Yi Chen
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Biao Liu
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Jun Chen
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Wenfang Nie
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Si Zhong
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Jing Ma
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Chang Liu
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China.
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China.
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