A few days ago, 39 Health learned from the Sixth Affiliated Hospital of Guangzhou Sun Yat-sen University that the intensive care unit (ICU) of the hospital admitted a female patient who was infected with Salmonella and caused multiple organ failure due to eating a lot of sushi.
Repeated abdominal pain, diarrhea and fever after a full meal, and he was in critical condition when he was admitted to hospital.
A Fang (pseudonym) who lives in Shenzhen is 36 years old. She is always in good health. She suddenly developed abdominal pain, diarrhea and fever 65,438+0 months ago. She thought she was all right, so she looked up some information on the Internet to buy medicine and took it herself. Because of the epidemic, she is worried about being isolated from the fever clinic. After three weeks, her family found that her mental state was getting worse and worse, and finally she was sleepy because of a high fever (40℃). After COVID-19-related fever was ruled out in the fever clinic, Dr. Chen Chunyu from Gastrointestinal attending surgeon was invited for an emergency consultation. It is found that A Fang has poor mental state, shallow breathing (30-40 beats/min) and indifferent consciousness. Bleeding spots are widely distributed on the skin and conjunctiva, accompanied by signs of diffuse peritonitis. Blood routine examination showed that the white blood cells were 37× 109/L, and the platelets were only 15. However, patients can only open their eyes and nod their heads to answer the doctor's instructions, and their families can't provide medical history information that is helpful for diagnosis. The patient had dysfunction of respiratory, circulatory, blood, kidney, central, internal environment, digestive tract and other organ systems, and was admitted to ICU for emergency treatment.
Dr. Shi, the chief physician of Fang's ICU, said that any further failure of organ system function will lead to fatal consequences, but the patient already has seven organ system dysfunction, and with the progress of the disease, there has also been a serious "death triad"-severe hypothermia, severe acidosis and coagulation dysfunction. In order to save this young life, Chief Physician Yang Chunhua, director of the Department of Critical Care Medicine, contacted the hospital to open a green rescue channel, and organized multidisciplinary teams such as the Department of Critical Care Medicine, Gastrointestinal Surgery, Hepatobiliary Surgery, Hematology, Ultrasound, Laboratory, Blood Transfusion, etc., and immediately carried out rescue treatment-ventilator, pressor, anti-infection, blood purification, blood transfusion, fluid replacement, hemodynamic monitoring, mitochondrial number monitoring, etc., and soon there were various patients.
After more than 20 days of rescue, vital signs recovered, and eating sushi contaminated with salmonella was the inducement.
As a result of abdominal emergency CT, a large amount of ascites can be seen, and the patient's life is at stake, showing signs of peritonitis. With the full trust of patients and their families, after multidisciplinary emergency consultation, anesthesia department took great risks to carry out anesthesia escort and gastrointestinal surgery to carry out emergency laparoscopic exploration. Unfortunately, no organ necrosis or perforation was found, and the patient's diagnosis has always been a mystery! What made Fang, who was young and healthy, so dangerous?
The reason was finally found-the laboratory opened a green channel, Afang's blood culture results suggested that Salmonella was detected, and the bone marrow reading in the pathology department ruled out blood diseases! At this time, the doctor asked the family members about their eating habits again. It turns out that A Fang usually likes to eat cold food such as sushi, and she had eaten a lot of sushi before she got sick.
Yang Chunhua carefully examined the patient, combined with supplementary medical history and various examination results, and made it clear that the chief culprit of the patient's critical condition was Salmonella. Because patients ate cold food contaminated by salmonella, a large number of salmonella entered the blood through the digestive tract, causing severe septic shock and leading to multiple organ dysfunction.
If the reason is found, it will be easy! After targeted treatment and active symptomatic support treatment, with the active cooperation and concerted efforts of ICU, gastrointestinal surgery, hematology, ultrasound, gastroenterology, blood transfusion, laboratory and other disciplines, after more than 20 days of efforts, the "death triad" finally reversed, and Afang's organ function gradually improved, and her vital signs gradually stabilized, leaving the functions of bedside hemodialysis machines, ventilators, pressers and other organs.
Yang Chunhua introduced that Salmonella is widely distributed in nature, often parasitic in the digestive system of humans and animals, and meat, eggs, milk and related products can be contaminated. Salmonella does not decompose and utilize protein, so it is difficult to judge whether food is contaminated by naked eyes or smell. Salmonella is a large class of bacteria with similar morphology and structure. More than 2000 kinds of bacteria have been found, including typhoid Bacillus. Salmonella can survive for more than 1 month in feces and for more than 2 weeks in water. Patients, asymptomatic carriers, domestic animals and wild animals can all become the source of infection of Salmonella. Patients usually have fever, diarrhea, abdominal pain and other symptoms after contact with infectious sources within 1 to 3 days. Patients with blood infection reported in the past will have serious complications, poor prognosis and even death. Therefore, he reminded that if there are unwell symptoms such as vomiting, diarrhea or fever, you should go to the hospital as soon as possible.
Doing so can prevent salmonella infection.
1. Kitchenware for handling raw food and cooked food should be separated, and raw food and cooked food should be avoided in the same area and floor of the refrigerator. Put cooked food on the upper floor and food on the lower floor to prevent cross-contamination.
Before eating raw fruits and vegetables, be sure to wash them with running tap water.
3. Cooked food should be kept at a low temperature below 10℃, and must be heated at a high temperature above 80℃ for more than 15 minutes before eating.
Pay attention to hand hygiene in daily life, and wash your hands before and after meals.
Don't eat raw or undercooked meat, eat raw eggs or drink raw milk.