Markedly elevated blood pressure, tachycardia, and altered consciousness in patients with bacteremia during transurethral surgeries: two case reports.

IF 0.8 Q3 ANESTHESIOLOGY

JA Clinical Reports Pub Date : 2025-02-17 DOI:10.1186/s40981-025-00774-z

Arisa Hotta, Momoka Nishimura, Daisuke Nakada, Riko Uchida, Hiroshi Matsuura, Naoko Torii, Naoko Fujita, Taku Hamada, Ai Nakamoto, Noriko Yoshikawa

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引用次数: 0

Abstract

Background: Transurethral surgery is often accompanied by postoperative urinary tract infection. Although early detection and adequate treatment of bacteremia are required to prevent sepsis, it is usually undetectable during surgery. We report two cases with remarkable hypertension and tachycardia during transurethral surgery in which bacteremia was diagnosed by an intraoperative blood test.

Case presentation: An 80-year-old man (Case 1) underwent transurethral holmium laser prostate enucleation under spinal anesthesia, and an 88-year-old woman (Case 2) underwent transurethral resection of bladder tumor under general anesthesia. Altered consciousness (Case 1) and postoperative delirium (Case 2) were noted, in addition to remarkable intraoperative hypertension and tachycardia. We administered broad-spectrum antibiotics for possible bacteremia in both cases. The patients' hemodynamics positively recovered the following day. Intraoperative blood samples revealed gram-negative bacillus.

Conclusions: Hypertension, tachycardia, and altered consciousness may suggest the onset of symptomatic bacteremia during transurethral surgery, and adequate treatment is required to prevent sepsis.

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经尿道手术中菌血症患者血压明显升高、心动过速和意识改变：两例报告。

背景：经尿道手术常伴有术后尿路感染。虽然早期发现和适当治疗菌血症是预防败血症的必要条件，但在手术中通常无法检测到。我们报告两例明显的高血压和心动过速在经尿道手术中，细菌血症被诊断为术中血液检查。病例介绍：一例80岁男性（病例1）在脊髓麻醉下行经尿道钬激光前列腺切除术，一例88岁女性（病例2）在全身麻醉下行经尿道膀胱肿瘤切除术。注意到意识改变（病例1）和术后谵妄（病例2），此外还有明显的术中高血压和心动过速。在这两例病例中，我们使用广谱抗生素治疗可能的菌血症。次日患者血流动力学阳性恢复。术中血样显示革兰氏阴性杆菌。结论：高血压、心动过速和意识改变可能提示经尿道手术中出现症状性菌血症，需要适当的治疗以预防败血症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JA Clinical Reports ANESTHESIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.