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Influenza-associated septic shock accompanied by septic cardiomyopathy that developed in summer and mimicked fulminant myocarditis

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  • Influenza-associated septic shock accompanied by septic cardiomyopathy that developed in summer and mimicked fulminant myocarditis

    Acute Med Surg. 2019 Feb 10;6(2):192-196. doi: 10.1002/ams2.394. eCollection 2019 Apr.
    Influenza-associated septic shock accompanied by septic cardiomyopathy that developed in summer and mimicked fulminant myocarditis.

    Fujioka M1,2, Suzuki K1,3,4, Iwashita Y1, Imanaka-Yoshida K5, Ito M2, Katayama N4, Imai H1.
    Author information

    Abstract

    Case:

    Fulminant myocarditis (FM) and septic cardiomyopathy (SC) are two different disease entities, and distinction between them is important. A 34-year-old man had refractory shock, multiple organ failure, and elevation of cardiogenic markers. Echocardiogram showed tachycardia with extended ST elevation, and a rapid test for influenza A virus was positive. He was admitted with suspected FM induced by influenza.
    Outcome:

    Echocardiography showed severe left ventricular dysfunction and dilatation, but no myocardial edema. Inconsistent with FM, a right heart catheter examination showed preserved cardiac output. Therefore, SC was considered and standard therapy for septic shock was initiated. He was stabilized in the first 72 h without mechanical circulatory support.
    Conclusion:

    Influenza A infection can cause septic shock accompanied by SC. This condition is confusing in the clinical appearance of FM. However, SC shows critically different features of FM, and it might not occur in the epidemic period.


    KEYWORDS:

    Fulminant myocarditis; influenza; sepsis‐induced cardiomyopathy; septic cardiomyopathy; septic shock

    PMID: 30976448 PMCID: PMC6442530 DOI: 10.1002/ams2.394
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