Abstract
BackgroundIt is not unusual for systemic diseases to mimic sepsis and, in any case, the clinician should thoroughly investigate this possibility.Case presentationWe present the case of a 21-year-old Greek woman who presented to the Intensive Care Unit of our hospital with severe septic shock – multiple organ failure as a result of a suspected gynecological infection of the ovaries. An immediate improvement of her clinical condition in combination with strong clinical suspicion and negative cultures led to the differential diagnosis of diseases other than sepsis. Based on the results of the biopsies that were obtained by research laparotomy, our patient suffered from primary Burkitt ovarian lymphoma. Her clinical condition improved with supportive treatment and chemotherapy. Chemotherapy is the dominant treatment for Burkitt’s lymphoma, while surgery or radiotherapy has no place.ConclusionsAll intensivists should be aware of clinical conditions that mimic sepsis as early diagnosis can lead to appropriate therapy and avoid unnecessary diagnostic tests and antibiotic abuse.
Highlights
It is not unusual for systemic diseases to mimic sepsis and, in any case, the clinician should thoroughly investigate this possibility.Case presentation: We present the case of a 21-year-old Greek woman who presented to the Intensive Care Unit of our hospital with severe septic shock – multiple organ failure as a result of a suspected gynecological infection of the ovaries
We present the case of a patient with clinical presentation of severe septic shock and multiple organ failure syndrome due to a suspected internal inflammatory disease
While waiting for blood and biopsy results, she was treated for septic shock, but due to the immediate improvement in her clinical condition and hemodynamic instability, the differential diagnosis turned to other diseases, such as ovarian hyperstimulation syndrome (OHSS) and low differentiation lymphomas
Summary
Primary bilateral non-Hodgkin lymphoma of the ovaries, a subtype of Burkitt’s lymphoma, was first observed by L. Due to acute renal failure, she was placed in continuous venous-venous hemofiltration (CVVHDF) While she was in our ICU she showed progressive clinical, gasometric, and hemodynamic improvement, draining ~ 2000 ml of ascitic fluid/day; on the third day of admission an attempt was made to wean her from the ventilator, pending the results of the cultures and ovarian and appendix biopsies. On the fourth day of admission, the results of blood and ascites fluid cultures were negative and biopsy results showed high-grade Burkitt lymphoma of the ovaries and the appendix With these data our patient was transported to a specialized oncology center for immediate onset of chemotherapy and further treatment. On the 15th day she left the ICU and on the 28th day she was discharged from hospital, presenting improved clinical and laboratory condition, waiting for further cycles of chemotherapy
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