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Capillary leakage complicated by compartment syndrome necessitating surgery
1Service de Réanimation Polyvalente, Hôpital Saint-Antoine, Paris, France.
Intensive Care Medicine
|January 1, 1990
Summary
Systemic capillary leak syndrome in an HIV-positive patient caused severe shock and compartment syndrome. Aggressive fluid resuscitation worsened muscle damage, highlighting the need for muscular pressure monitoring during treatment.
Area of Science:
- Internal Medicine
- Infectious Diseases
- Critical Care Medicine
Background:
- Systemic capillary leak syndrome (SCLS) is a rare disorder characterized by recurrent episodes of plasma leakage.
- Human Immunodeficiency Virus (HIV) infection can be associated with various systemic complications.
Observation:
- A case of SCLS occurred in a patient with HIV.
- The patient experienced hypovolemic shock requiring substantial fluid resuscitation.
- This led to diffuse swelling, significant weight gain, and bilateral leg compartment syndrome necessitating surgical intervention.
Findings:
- Initial laboratory findings included high hematocrit (62%) and low serum protein (48 g/l).
- Normal Factor V concentrations were noted, which are typical in SCLS.
- The high hematocrit and low serum protein are hallmarks of capillary leak associated with hypovolemic shock.
Implications:
- Aggressive fluid resuscitation in SCLS with severe shock can exacerbate muscle damage and lead to compartment syndrome.
- Monitoring intramuscular pressure during fluid resuscitation in patients with SCLS, shock, and swelling is recommended.
- This case underscores the complex management of SCLS in the context of HIV infection.