Nursing care in a case of acute infectious purpura fulminans caused by Streptococcus pyosus infection

doi:10.3877/cma.j.issn.2096-1537.2024.01.015

Abstract

Abstract:

To summarize the nursing critical points in a case of acute infectious purpura fulminans caused by Streptococcus pyogenes, which include a comprehensive hemodynamic assessment to effectively guide fluid resuscitation, the nursing of blood purification, wound treatment, fine medication management, prevention and care of thromboembolism, posture management and catheter care. After effective treatment and careful nursing, the patient's condition improved and was discharged from hospital after 28 days.

Key words: Streptococcus pyogenes, Acute infection, Explosive purpura, Nursing

Xiaolin Sun, Shiqin Pan, Zongzhao He, Siqing Ma, Qin. Ma. Nursing care in a case of acute infectious purpura fulminans caused by Streptococcus pyosus infection[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2024, 10(01): 90-96.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://icu.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2096-1537.2024.01.015

https://icu.cma-cmc.com.cn/EN/Y2024/V10/I01/90

Figures/Tables 10

References 24

1	Song Y, Zhang X, Cai M, et al. The heme transporter HtsABC of group A Streptococcus contributes to virulence and innate immune evasion in murine skin infections [J]. Front Microbiol, 2018, 9: 1105.
2	Ali S, Elseed M. PANPACH: the First Independent Paediatric Workshop of the Pan African Network for Paediatric and Congenital Heart (PANPACH) [J]. Eur Heart J, 2017, 38(47): 3483-3485.
3	Okuzono S, Ishimura M, Kanno S, et al. Streptococcus pyogenes-purpura fulminans as an invasive form of group A streptococcal infection [J]. Ann Clin Microbiol Antimicrob, 2018, 17(1): 31.
4	Wheaton T, Menkiti O, Misra A. Streptococcus pyogenes purpura fulminans andseptic shock: a case highlighting the ethical considerations of high-risk extracorporeal membrane oxygenation [J]. Int J Artif Organs, 2020, 43: 500-502.
5	王本超, 金林鑫, 陈森, 等. 化脓性链球菌感染致成人急性感染性暴发性紫癜的治疗及文献回顾 [J]. 中国急救医学, 2019, 39(5): 476-479.
6	Natalini G, Schivalocchi V, Rosano A, et al. Norepinephrine and metaraminol in septic shock: a comparison of the hemodynamic effects [J]. Intensive Care Med, 2005, 31(5): 634-637.
7	中国医师协会急诊医师分会, 中国研究型医院学会休克与脓毒症专业委员会. 中国脓毒症/脓毒性休克急诊治疗指南(2018) [J]. 中国急救医学, 2018, 38(9): 741-756.
8	Cohn JN. Blood pressure measurement in shock. Mechanism of inaccuracy in ausculatory and palpatory methods [J]. JAMA, 1967, 199(13): 118-122.
9	Hollenberg SM, Parrillo JE, Braunwald E, et al. Harrison's principles of internal medicine [M]. 14th ed. New York: McGraw-Hill, 1997: 214-222.
10	张秀丽, 郭亮, 林乐清. PICCO联合重症超声在脓毒性休克伴心功能不全患者中的应用 [J]. 中国现代医生, 2021, 59(24): 114-116, 121.
11	Ronco C, Reis T, De Rosa S. Coronavirus epidemic and extracorporeal therapies in intensive care: sivis pacem para bellum [J]. Blood Purif, 2020, 49(3): 255-258.
12	赵菊馨, 吴金海, 秦历杰. 血液灌流在脓毒症患者中的应用现状 [J]. 实用休克杂志(中英文), 2020, 4(6): 324-326.
13	陈晓, 游广涵, 眭玉霞. 美罗培南不同输注方案对治疗重症肺炎的临床效果观察 [J]. 福建医药杂志, 2021, 43(4): 55-57.
14	吴晓鹏, 张金花, 张彬. 美罗培南联合乌司他丁治疗细菌性脓毒血症及对血清降钙素原与炎症因子的影响 [J]. 西北药学杂志, 2019, 34(6): 814-818.
15	张彬, 吴晓鹏, 张金花, 等. 美罗培南持续泵入对脓毒血症多重耐药菌患者的临床疗效研究 [J]. 中国实用医药, 2021, 16(25): 158-160.
16	高伟, 曹鹏, 倪海滨, 等. 脓毒性休克患者舌色与舌下微循环及预后关系 [J]. 北京中医药大学学报, 2019, 42(2): 171-176.
17	Brunauer A, Koköfer A, Bataar O, et al. Changes in peripheral pedusion relate to visceral organ perfusion in early septic shock: A pilot study [J]. J Crit Care, 2016, 35: 105-109.
18	卞红, 俞萍. 早期目标导向活动方案对ICU机械通气病人获得性衰弱的影响 [J]. 护理研究, 2021, 35(7): 1248-1251.
19	张帅, 陈娟红, 富燕萍, 等. 早期目标导向活动在心脏术后患者康复中的应用效果 [J]. 中华现代护理杂志, 2020, 26(33): 4640-4644.
20	黄小芳, 李玉宁, 郭琼. 术后低半卧位对口腔颌面肿瘤游离皮瓣移植修复术患者创面愈合效果、疼痛的影响 [J]. 四川生理科学杂志, 2022, 44(3): 545-546, 407.
21	中华医学会重症医学分会. 机械通气临床应用指南 [J]. 中国危重病急救医学, 2007, 19(2): 65-72.
22	Alexiou VC, Lerodiakonou V, Dimopoulos G, et al.Impact of patient position on the incidence of ventilator--associated pneu- monia: a meta-analysis of randomized controlled trials [J]. J Crit Care, 2009, 24(4): 515-522.
23	丘宇茹, 王吉文, 莫红平, 等. 临床管道固定护理质量评价指标体系的构建研究 [J]. 护理管理杂志, 2020, 20(11): 813-817.
24	罗玉珍, 汪海芹, 高明珠, 等. 不同部位动脉置管监测有创血压在ICU危重患者中应用效果 [J]. 临床护理杂志, 2016, 15(6): 27-29.

[1]	Hanli Pan, Jing He, Yuanyuan Chen, Mengyao Jia, Xing Zhao, Pei Yang. Application of enhanced recovery after surgery nursing during perioperative period of robot assisted total hip replacement [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2024, 18(01): 142-146.
[2]	Xing Shao, Ling Liu, Xian Zhang, Zairong Wei. Observation on the effect of comprehensive nursing after repairing middle facial defect with facial artery perforator relay flap [J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2024, 19(01): 57-60.
[3]	Na Shi, Xiaoyan Jin, Hui Chen. Research progress of continuous rehabilitation care for adult patients with hand burns [J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2024, 19(01): 68-72.
[4]	Yiman Zhou, Xiuwu Pan, Xingang Cui, Yunxin Tan, Jun Gu. Application of risk warning care model in preventing venous thromboembolism in patients undergoing robot-assisted urologic surgery [J]. Chinese Journal of Endourology(Electronic Edition), 2024, 18(01): 52-57.
[5]	Jing Huang, Yuhuan Shang. Evaluation of the impact of comprehensive nursing management on the discharge readiness of patients undergoing day-case inguinal hernia surgery [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2024, 18(01): 61-64.
[6]	Yixiang Wang, Fangfang Yin, Yan Yan. Analysis of intervention effect in elderly patients with inguinal hernia using comprehensive high-quality nursing [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2024, 18(01): 116-120.
[7]	Xue Li, Wenting Liu, Liting Dou, Yehong Liu. Effect analysis of combined nursing in laparoscopic hiatal hernia repair [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(06): 750-754.
[8]	Hongyan Wang, Yanli Ma, Jiecan Zheng. The effectiveness of comprehensive nursing in the operating room for inguinal hernia surgery [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(06): 755-758.
[9]	Gege Dai, Li Yang, Yuanyuan Hu, Wenting Zhou. Application effect of comprehensive intervention in operating room in elderly patients with inguinal hernia [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(06): 759-763.
[10]	Lei Wang, Shaohua Wang, Haizhen Niu, Tengfei Yin. Application of early warning intervention based on risk assessment in perioperative nursing of children with inguinal hernia [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(06): 768-772.
[11]	Qingqing Zhu, Zhenqi Wei. Application value of self-efficacy management during perioperative period in patients with inguinal hernia [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(06): 773-777.
[12]	Rui Huang, Yuping Wang, Qian Sun, Xiaohong Hou. Analysis of the best evidence of enteral nutrition complicated with diarrhea in ICU patients [J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2024, 10(01): 38-41.
[13]	Wenwen Shi, Ying Liu, Lei Yu, Xiuhua Wang. Current status and influencing factors of knowledge, attitude, and practice towards narrative nursing among 1791 tuberculosis department nurses: a national survey [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(10): 1123-1128.
[14]	Shuping Huang, Bei Gong, Tiemei Shen, Danli Yang, Xiumei Chen, Guoqi Li, Xing Li, Aihuan Mai, Bing Zhong, Guangdong Nurses Association Cardiovascular Disease Nursing Branch, Southern Cardiovascular Nursing Alliance. Expert consensus on perioperative nursing care of patients with atrial fibrillation undergoing interventional surgery [J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2024, 12(01): 1-9.
[15]	Ying Li, Yan Liang, Ruixian He. Application and exploration of KTH integrated intervention model in nursing care of hepatic artery infusion chemotherapy for liver cancer [J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2024, 12(01): 82-85.

Please choose a citation manager

Content to export