DerAnaesthesist.50440869.ger.abstr-passage-0
abstract
Wir berichten ueber den seltenen Fall eines nicht-menstruellen Toxic-Shock-Syndroms ( TSS ) im Rahmen einer abszedierenden S. aureus-Sepsis bei einer 31jaehrigen graviden Patientin , welche am Ende der 29. Schwangerschaftswoche innerhalb von Stunden eine schwerste respiratorische und kardiozirkulatorische Insuffizienz entwickelte . Auch nach der notfallmaessigen Forzepsentbindung konnte trotz aller intensivmedizinischer Massnahmen keine Stabilisierung des Allgemeinzustands erreicht werden . Die Patientin verstarb wenige Stunden postpartal unter den Zeichen eines Multiorganversagens . Post mortem fanden sich neben multiplen staphylogenen Abszedierungen in Nieren , Leber und Uterus eine akut , ulzeroese Endokarditis der Mitralklappe sowie septische myokardiale Streuherde mit begleitender Myokarditis . Der aus Blutkulturen isolierte S. aureus-Stamm verfuegte ueber die Faehigkeit zur Produktion von Toxic-Shock-Syndrome-Toxin-1 ( TSST-1) und Enterotoxin B. Das TSS , bei dem man ein menstruelles ( 80-90% ) von einem nicht-menstruellen TSS ( 10-20% ) unterscheidet , wird durch die Hauptsymptome Fieber , Hypotonie , Schleimhauthyperaemie und Exanthem sowie eine Reihe von Nebensymptomen wie z.B. Myalgien , Erbrechen , Diarrhoe charakterisiert . Schwere Krankheitsverlaeufe sind mit Stoerungen multipler Organsysteme bis hin zum Multiorganversagen verbunden . Pathogenetisch liegen dem TSS lokale selten generalisierte Infektionen , mit S. aureus-Staemmen zugrunde , welche ueber die Faehigkeit zur Produktion von Toxinen mit Superantigencharakter verfuegen ( Enterotoxine TSST-1). , Die Letalitaet des nicht-menstruellen TSS ist hoch und wird mit 8-11% angegeben . Im Vordergrund der Therapie steht derzeit neben der antibiotischen Therapie die symptomatische Behandlung der Hypotension sowie begleitender Organstoerungen .
DerAnaesthesist.50440869.ger.abstr-s5-r1-t8.1-t5.1
degree_of
DerAnaesthesist.50440869.ger.abstr-s5-t8
DerAnaesthesist.50440869.ger.abstr-s5-t5
DerAnaesthesist.50440869.ger.abstr-s5-r2-t5.1-t7.1
degree_of
DerAnaesthesist.50440869.ger.abstr-s5-t5
DerAnaesthesist.50440869.ger.abstr-s5-t7
DerAnaesthesist.50440869.ger.abstr-s5-r3-t8.1-t5.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s5-t8
DerAnaesthesist.50440869.ger.abstr-s5-t5
DerAnaesthesist.50440869.ger.abstr-s5-r4-t7.1-t1.1
produces
DerAnaesthesist.50440869.ger.abstr-s5-t7
DerAnaesthesist.50440869.ger.abstr-s8-t1
DerAnaesthesist.50440869.ger.abstr-s5-r5-t5.1-t3.1
co-occurs_with
DerAnaesthesist.50440869.ger.abstr-s5-t5
DerAnaesthesist.50440869.ger.abstr-s8-t3
DerAnaesthesist.50440869.ger.abstr-s5-r6-t1.1-t5.1
location_of
DerAnaesthesist.50440869.ger.abstr-s8-t1
DerAnaesthesist.50440869.ger.abstr-s5-t5
DerAnaesthesist.50440869.ger.abstr-s5-r7-t3.1-t8.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s8-t3
DerAnaesthesist.50440869.ger.abstr-s5-t8
DerAnaesthesist.50440869.ger.abstr-s5-r8-t8.1-t3.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s5-t8
DerAnaesthesist.50440869.ger.abstr-s8-t3
DerAnaesthesist.50440869.ger.abstr-s5-r9-t3.1-t7.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s8-t3
DerAnaesthesist.50440869.ger.abstr-s5-t7
DerAnaesthesist.50440869.ger.abstr-s5-r10-t5.1-t10.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s5-t5
DerAnaesthesist.50440869.ger.abstr-s5-t10
DerAnaesthesist.50440869.ger.abstr-s5-r11-t3.1-t5.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s8-t3
DerAnaesthesist.50440869.ger.abstr-s5-t5
DerAnaesthesist.50440869.ger.abstr-s5-r12-t8.1-t10.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s5-t8
DerAnaesthesist.50440869.ger.abstr-s5-t10
DerAnaesthesist.50440869.ger.abstr-s5-r13-t5.1-t1.2
produces
DerAnaesthesist.50440869.ger.abstr-s5-t5
DerAnaesthesist.50440869.ger.abstr-s8-t1
DerAnaesthesist.50440869.ger.abstr-s5-r14-t5.1-t8.1
co-occurs_with
DerAnaesthesist.50440869.ger.abstr-s5-t5
DerAnaesthesist.50440869.ger.abstr-s5-t8
DerAnaesthesist.50440869.ger.abstr-s5-r15-t6.1-t8.1
location_of
DerAnaesthesist.50440869.ger.abstr-s5-t6
DerAnaesthesist.50440869.ger.abstr-s5-t8
DerAnaesthesist.50440869.ger.abstr-s5-r16-t5.1-t8.1
degree_of
DerAnaesthesist.50440869.ger.abstr-s5-t5
DerAnaesthesist.50440869.ger.abstr-s5-t8
DerAnaesthesist.50440869.ger.abstr-s5-r17-t7.1-t6.1
produces
DerAnaesthesist.50440869.ger.abstr-s5-t7
DerAnaesthesist.50440869.ger.abstr-s5-t6
DerAnaesthesist.50440869.ger.abstr-s5-r18-t7.1-t1.2
produces
DerAnaesthesist.50440869.ger.abstr-s5-t7
DerAnaesthesist.50440869.ger.abstr-s8-t1
DerAnaesthesist.50440869.ger.abstr-s5-r19-t7.1-t5.1
degree_of
DerAnaesthesist.50440869.ger.abstr-s5-t7
DerAnaesthesist.50440869.ger.abstr-s5-t5
DerAnaesthesist.50440869.ger.abstr-s5-r20-t1.2-t7.1
causes
DerAnaesthesist.50440869.ger.abstr-s8-t1
DerAnaesthesist.50440869.ger.abstr-s5-t7
DerAnaesthesist.50440869.ger.abstr-s5-r21-t5.1-t9.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s5-t5
DerAnaesthesist.50440869.ger.abstr-s5-t9
DerAnaesthesist.50440869.ger.abstr-s5-r22-t6.1-t7.1
location_of
DerAnaesthesist.50440869.ger.abstr-s5-t6
DerAnaesthesist.50440869.ger.abstr-s5-t7
DerAnaesthesist.50440869.ger.abstr-s5-r23-t5.1-t8.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s5-t5
DerAnaesthesist.50440869.ger.abstr-s5-t8
DerAnaesthesist.50440869.ger.abstr-s5-r24-t5.1-t7.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s5-t5
DerAnaesthesist.50440869.ger.abstr-s5-t7
DerAnaesthesist.50440869.ger.abstr-s5-r25-t7.1-t10.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s5-t7
DerAnaesthesist.50440869.ger.abstr-s5-t10
DerAnaesthesist.50440869.ger.abstr-s5-r27-t5.1-t3.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s5-t5
DerAnaesthesist.50440869.ger.abstr-s8-t3
DerAnaesthesist.50440869.ger.abstr-s5-r28-t6.1-t5.1
location_of
DerAnaesthesist.50440869.ger.abstr-s5-t6
DerAnaesthesist.50440869.ger.abstr-s5-t5
DerAnaesthesist.50440869.ger.abstr-s5-r29-t8.1-t1.1
produces
DerAnaesthesist.50440869.ger.abstr-s5-t8
DerAnaesthesist.50440869.ger.abstr-s8-t1
DerAnaesthesist.50440869.ger.abstr-s5-r30-t6.1-t1.2
surrounds
DerAnaesthesist.50440869.ger.abstr-s5-t6
DerAnaesthesist.50440869.ger.abstr-s8-t1
DerAnaesthesist.50440869.ger.abstr-s5-r31-t1.2-t8.1
causes
DerAnaesthesist.50440869.ger.abstr-s8-t1
DerAnaesthesist.50440869.ger.abstr-s5-t8
DerAnaesthesist.50440869.ger.abstr-s5-r32-t1.2-t5.1
causes
DerAnaesthesist.50440869.ger.abstr-s8-t1
DerAnaesthesist.50440869.ger.abstr-s5-t5
DerAnaesthesist.50440869.ger.abstr-s5-r33-t7.1-t9.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s5-t7
DerAnaesthesist.50440869.ger.abstr-s5-t9
DerAnaesthesist.50440869.ger.abstr-s5-r35-t1.2-t6.1
derivative_of
DerAnaesthesist.50440869.ger.abstr-s8-t1
DerAnaesthesist.50440869.ger.abstr-s5-t6
DerAnaesthesist.50440869.ger.abstr-s5-r36-t5.1-t9.1
co-occurs_with
DerAnaesthesist.50440869.ger.abstr-s5-t5
DerAnaesthesist.50440869.ger.abstr-s5-t9
DerAnaesthesist.50440869.ger.abstr-s5-r37-t1.1-t8.1
location_of
DerAnaesthesist.50440869.ger.abstr-s8-t1
DerAnaesthesist.50440869.ger.abstr-s5-t8
DerAnaesthesist.50440869.ger.abstr-s5-r38-t7.1-t8.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s5-t7
DerAnaesthesist.50440869.ger.abstr-s5-t8
DerAnaesthesist.50440869.ger.abstr-s5-r39-t5.1-t3.1
evaluation_of
DerAnaesthesist.50440869.ger.abstr-s5-t5
DerAnaesthesist.50440869.ger.abstr-s8-t3
DerAnaesthesist.50440869.ger.abstr-s5-r40-t1.1-t7.1
location_of
DerAnaesthesist.50440869.ger.abstr-s8-t1
DerAnaesthesist.50440869.ger.abstr-s5-t7
DerAnaesthesist.50440869.ger.abstr-s5-r41-t7.1-t5.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s5-t7
DerAnaesthesist.50440869.ger.abstr-s5-t5
DerAnaesthesist.50440869.ger.abstr-s5-r42-t8.1-t6.1
produces
DerAnaesthesist.50440869.ger.abstr-s5-t8
DerAnaesthesist.50440869.ger.abstr-s5-t6
DerAnaesthesist.50440869.ger.abstr-s5-r43-t8.1-t9.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s5-t8
DerAnaesthesist.50440869.ger.abstr-s5-t9
DerAnaesthesist.50440869.ger.abstr-s5-r44-t5.1-t10.1
co-occurs_with
DerAnaesthesist.50440869.ger.abstr-s5-t5
DerAnaesthesist.50440869.ger.abstr-s5-t10
DerAnaesthesist.50440869.ger.abstr-s5-r45-t8.1-t1.2
produces
DerAnaesthesist.50440869.ger.abstr-s5-t8
DerAnaesthesist.50440869.ger.abstr-s8-t1
DerAnaesthesist.50440869.ger.abstr-s5-r46-t7.1-t3.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s5-t7
DerAnaesthesist.50440869.ger.abstr-s8-t3
DerAnaesthesist.50440869.ger.abstr-s7-r1-t2.1-t1.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s8-t2
DerAnaesthesist.50440869.ger.abstr-s8-t1
DerAnaesthesist.50440869.ger.abstr-s7-r2-t4.1-t2.1
interacts_with
DerAnaesthesist.50440869.ger.abstr-s8-t4
DerAnaesthesist.50440869.ger.abstr-s8-t2
DerAnaesthesist.50440869.ger.abstr-s7-r3-t2.1-t1.1
affects
DerAnaesthesist.50440869.ger.abstr-s8-t2
DerAnaesthesist.50440869.ger.abstr-s8-t1
DerAnaesthesist.50440869.ger.abstr-s7-r4-t4.1-t1.1
affects
DerAnaesthesist.50440869.ger.abstr-s8-t4
DerAnaesthesist.50440869.ger.abstr-s8-t1
DerAnaesthesist.50440869.ger.abstr-s7-r5-t1.1-t2.1
produces
DerAnaesthesist.50440869.ger.abstr-s8-t1
DerAnaesthesist.50440869.ger.abstr-s8-t2
DerAnaesthesist.50440869.ger.abstr-s7-r6-t2.1-t4.1
interacts_with
DerAnaesthesist.50440869.ger.abstr-s8-t2
DerAnaesthesist.50440869.ger.abstr-s8-t4
DerAnaesthesist.50440869.ger.abstr-s7-r7-t1.1-t2.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s8-t1
DerAnaesthesist.50440869.ger.abstr-s8-t2
DerAnaesthesist.50440869.ger.abstr-s8-r1-t4.1-t1.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s8-t4
DerAnaesthesist.50440869.ger.abstr-s8-t1
DerAnaesthesist.50440869.ger.abstr-s8-r2-t1.2-t4.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s8-t1
DerAnaesthesist.50440869.ger.abstr-s8-t4
DerAnaesthesist.50440869.ger.abstr-s8-r3-t2.2-t4.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s8-t2
DerAnaesthesist.50440869.ger.abstr-s8-t4
DerAnaesthesist.50440869.ger.abstr-s8-r4-t1.1-t4.1
associated_with
DerAnaesthesist.50440869.ger.abstr-s8-t1
DerAnaesthesist.50440869.ger.abstr-s8-t4
DerAnaesthesist.50440869.ger.abstr-s8-r5-t4.1-t2.2
associated_with
DerAnaesthesist.50440869.ger.abstr-s8-t4
DerAnaesthesist.50440869.ger.abstr-s8-t2
DerAnaesthesist.50440869.ger.abstr-s8-r6-t4.1-t1.2
associated_with
DerAnaesthesist.50440869.ger.abstr-s8-t4
DerAnaesthesist.50440869.ger.abstr-s8-t1