Preoperative management of septic shock due to cellulitis cruris
Management of septic shock in cellulitis cruris
DOI:
https://doi.org/10.59747/smjidisurabaya.v3i1.100Keywords:
Septic shock, cellulitis, acute kidney injury, debridement anesthesiaAbstract
Background: Septic shock is an emergency condition due to a systemic inflammatory response to infection, which can lead to multiple organ failure. Soft tissue infections such as cellulitis are one of the causes of sepsis, especially if not treated properly. Management of septic shock includes hemodynamic stabilization, antibiotic therapy, and control of the source of infection through debridement. The main challenge in this procedure is the risk of hemodynamic instability during anesthesia. Case Illustration: A 51-year-old man came with complaints of weakness and decreased consciousness, preceded by swelling and pain in the left leg. Examination showed septic shock with hypotension (69/45 mmHg), leukocytosis (34,000/µL), and AKI (creatinine 2.58 mg/dL). Fluid resuscitation and initial stabilization were performed before debridement. Anesthesia used total intravenous anesthesia (TIVA) with ketamine and sufentanil, and close monitoring with vasopressors. Conclusion: Management of septic shock due to cellulitis requires a multidisciplinary approach. Early stabilization, debridement, and appropriate anesthetic techniques play an important role in improving the patient's prognosis.
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