ATYPICAL COURSE OF ACUTE SEPSIS AFTER MINOR SURGERY WITH MANIFESTATION IN THE FORM OF SECONDARY PURULENT-INFLAMMATORY GYNECOLOGICAL PATHOLOGY
Using the example of atypical variant of the septicаemic condition development with predominant affection of external genital organs in a 22-year-old woman, we established early diagnostic criteria for this complication in one-day surgery. Patient underwent dental extraction shortly before admission to hospital. On the second day from the moment of possible infection a purulent-resorptive fever was developed. On the fourth day patient status became more severe, hyperthermia to 38,5°С a large number of painful vesicles-pustular rash on the back skin, buttocks, lower limbs, foci of purulent inflammation in the genital area.
After clinical laboratory, bacteriological and instrument studies, consultations of related specialists, a clinical diagnosis was established: “Staphylococcal sepsis MRSA. Purulent-necrotic vulvovaginitis. Vesicular-papular (MRSA-staphylococcal) lesions of the skin of the trunk, lower extremities and oral mucosa”
According to international protocols of sepsis management, a schema of intensive pharmacological and local therapy was applied, as well as sanitation of foci with antiseptics. Patient in satisfactory condition was discharged from hospital after 30-days treatment.
Conclusions. A rapidly course and atypical clinical manifestation of purulent-septic complications can significantly impede their early diagnosis after minor surgical interventions. Rigorous anamnesis collection, comparison of all symptoms, that are not related at first glance, bacteriological examination serialization and consultations with related specialists, as well as intensive antibacterial and local therapies allow to make correct diagnostic on time and regress disease.
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