A Case of Severe Ebola Virus Infection Complicated by Gram-Negative Septicemia

被引：246

作者：

Kreuels, Benno ^{[1
,5
,6
]}

Wichmann, Dominic ^{[2
]}

Emmerich, Petra ^{[7
]}

Schmidt-Chanasit, Jonas ^{[5
,7
]}

de Heer, Geraldine ^{[2
]}

Kluge, Stefan ^{[2
]}

Sow, Abdourahmane ^{[8
,9
,10
]}

Renne, Thomas ^{[3
,11
]}

Guenther, Stephan ^{[5
,7
]}

Lohse, Ansgar W. ^{[1
,5
]}

Addo, Marylyn M. ^{[1
,5
,12
]}

Schmiedel, Stefan ^{[1
,4
,5
]}

机构：

[1] Univ Med Ctr Hamburg Eppendorf, Dept Med 1, Div Trop Med, D-20246 Hamburg, Germany

[2] Univ Med Ctr Hamburg Eppendorf, Dept Intens Care Med, D-20246 Hamburg, Germany

[3] Univ Med Ctr Hamburg Eppendorf, Inst Clin Chem & Lab Med, D-20246 Hamburg, Germany

[4] Univ Med Ctr Hamburg Eppendorf, Infect Dis Unit Outpatient Care, D-20246 Hamburg, Germany

[5] German Ctr Infect Res, Hamburg, Germany

[6] Bernhard Nocht Inst Trop Med, Res Grp Infect Dis Epidemiol, D-20359 Hamburg, Germany

[7] Bernhard Nocht Inst Trop Med, World Hlth Org Collaborating Ctr Arbovirus & Hemo, D-20359 Hamburg, Germany

[8] Inst Pasteur, Arboviruses & Hemorrhag Fever Viruses Unit, Dakar, Senegal

[9] Cheikh Anta Diop Univ, Publ Hlth & Dev Inst, Dakar, Senegal

[10] Bordeaux Univ, INSERM, U897, Bordeaux Publ Hlth Inst, Bordeaux, France

[11] Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden

[12] Massachusetts Gen Hosp, Infect Dis Unit, Boston, MA 02114 USA

来源：

NEW ENGLAND JOURNAL OF MEDICINE | 2014年 / 371卷 / 25期

关键词：

D O I：

10.1056/NEJMoa1411677

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Ebola virus disease (EVD) developed in a patient who contracted the disease in Sierra Leone and was airlifted to an isolation facility in Hamburg, Germany, for treatment. During the course of the illness, he had numerous complications, including septicemia, respiratory failure, and encephalopathy. Intensive supportive treatment consisting of high-volume fluid resuscitation (approximately 10 liters per day in the first 72 hours), broad-spectrum antibiotic therapy, and ventilatory support resulted in full recovery without the use of experimental therapies. Discharge was delayed owing to the detection of viral RNA in urine (day 30) and sweat (at the last assessment on day 40) by means of polymerase-chain-reaction (PCR) assay, but the last positive culture was identified in plasma on day 14 and in urine on day 26. This case shows the challenges in the management of EVD and suggests that even severe EVD can be treated effectively with routine intensive care.

引用

页码：2394 / 2401

页数：8

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