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Full Text: 
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¿µ³²ÀÇ´ëÇмúÁö Yeungnam Univ J Med 2018;35(1):84-88
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CASE REPORT
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A successful management after preterm delivery in a patient with
severe sepsis during third-trimester pregnancy |
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Moni Ra1, Myungkyu Kim1, Mincheol Kim1, Sangwoo Shim1, Seong Yeon Hong2
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Departments of 1Internal Medicine and 2Obstetrics and Gynecology, Catholic University of Daegu School of Medicine, Daegu, Korea
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Corresponding Author: Sangwoo Shim, Department of
Internal Medicine, Catholic University of Daegu School of
Medicine, 33, Duryugongwon-ro 17-gil, Nam-gu, Daegu
42472, Korea
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Tel: +82-53-650-4274, Fax: +82-53-621-4106
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E-mail: swshim@cu.ac.kr
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Received: August 6, 2016, Revised: October 30, 2016
Accepted: Accepted: October 31, 2016
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Abstract
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A 33-year-old woman visited the emergency department presenting with fever and dyspnea. She was pregnant
with gestational age of 31 weeks and 6 days. She had dysuria for 7 days, and fever and dyspnea for
1 day. The vital signs were as follows: blood pressure 110/70 mmHg, heart rate 118 beats/minute, respiratory
rate 28/minute, body temperature 38.7¡É, and oxygen saturation by pulse oximetry 84% during inhalation
of 5 liters of oxygen by nasal prongs. Crackles were heard over both lung fields. There were no signs
of uterine contractions. Chest X-ray and chest computed tomography scan showed multiple consolidations
and air bronchograms in both lungs. According to urinalysis, there was pyuria and microscopic hematuria.
She was diagnosed with community-acquired pneumonia and urinary tract infection (UTI) that progressed
to severe sepsis and acute respiratory failure. We found extended-spectrum beta-lactamase producing
Escherichia coli in the blood culture and methicillin-resistant Staphylococcus aureus in the sputum culture.
The patient was transferred to the intensive care unit with administration of antibiotics and supplementation
of high-flow oxygen. On hospital day 2, hypoxemia was aggravated. She underwent endotracheal intubation
and mechanical ventilation. After 3 hours, fetal distress was suspected. Under 100% fraction of inspired
oxygen, her oxygen partial pressure was 87 mmHg in the arterial blood. She developed acute kidney injury
and thrombocytopenia. We diagnosed her with multi-organ failure due to severe sepsis. After an emergent
cesarean section, pneumonia, UTI, and other organ failures gradually recovered. The patient and baby were
discharged soon thereafter.
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Key Words: Keywords: Infectious pregnancy complications; Sepsis; Infection
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