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Published on: December 8, 2023
A Young Man With Severe and Disabling Complications of Septic Shock
L E M Haas1, R S van der Ploeg2, J J Quak2
1L. E. M. Haas is an internist-intensivist, R. S. van der Ploeg is an ophthalmologist, J. J. Quak is an otorhinolaryngologist, J. P. J. Burgmans is a surgeon, and M. Otten is an anesthesiologist-intensivist at Diakonessenhuis, Utrecht, the Netherlands. lvlelyveld@diakhuis.nl.
Abstract:
A young man had severe septic shock with multiorgan failure due to necrotizing fasciitis caused by group A streptococcus after endoscopic repair of a preperitoneal inguinal hernia. He was treated with surgical exploration and antibiotics and resuscitated with fluids, vasopressors, and inotropic agents. He survived this critical illness, but when he woke up from sedation, his vision was lost in both eyes. Ophthalmological evaluation revealed minimal peripapillary retinal hemorrhages without signs of papillary edema. Visually evoked potentials were negative. Magnetic resonance imaging did not show a cause of the visual damage. The patient had bilateral ischemic optic neuropathy diagnosed. Two weeks later, unilateral sudden deafness also developed. The acquired blindness and hearing loss were unchanged after more than 1 year and seem to be permanent, severely disabling this young survivor of septic shock.
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