Cлучай развития септического миокардита и септикопиемии после инфицирования SARS-CoV-2

Abstract

Sepsis is a topical problem in medicine, especially in the course of the epidemic of a new coronavirus infection. Sepsis is based on the reaction of the body to infection in the form of generalized inflammation. The article describes a case of septic myocarditis and septicopyemia after infection with SARS-CoV-2. Description of the case. Patient S.S., born in 1976 was treated in the infectious diseases department with a diagnosis of new coronavirus infection COVID-19, severe course. Complications of the underlying disease: Bilateral interstitial pneumonia. ARDS. Sepsis. Complaints at admission: shortness of breath; heart palpitations and irregularities in the heart rhythm. He noted an increase in body temperature up to 38.2-38.50C. In connection with the deteriorating conditions, he called an ambulance and was admitted to the emergency department. Objective status: BP – 85/55 mm Hg. Heart rate – 111. Oxygen saturation – 64%. The assessment of the state on the NEWS2 scale is 11 points. Complete blood count: Leukocytes: 17.8 (3.39-8.86) 10 * 9/l, segmented neutrophils: 87% (40-68%), lymphocytes: 16% (19-37%), ESR: 69 (2-15) mm/hour. C-reactive protein (CRP): 24.5 mg/l (0-6) mg/l, Procalcitonin: 9 (0-0.064) ng/ml. CT of the chest revealed signs of bilateral viral interstitial pneumonia with a lesion area of 62%. ECG: nonspecific changes. SARS antigen – CoV-2 in swabs from the mucous membrane of the oropharynx by ICA: SARS coronavirus: detected. Despite treatment, the patient died. Sectional examination revealed signs of viral-bacterial pneumonia. In the heart – signs of acute heart failure; diffuse cellular infiltrates in the myocardium. In the spleen – plethora and leukocytosis of the red pulp. Conclusion: the patient had changes in the lungs in the form of viral-bacterial pneumonia and signs of septicopyemia with septic myocarditis and acute heart failure.