Acute Kidney Injury (AKI) in the Setting of Multi-Organ Dysfunction Syndrome (MODS) Secondary to Yellow Fever Infection (YFI) in a 19-Year-Old Woman

Acute Kidney Injury (AKI) in the Setting of Multi-Organ Dysfunction Syndrome (MODS) Secondary to Yellow Fever Infection (YFI) in a 19-Year-Old Woman

Author by Dr. Charles Elikwu

Journal/Publisher: Journal Of Biosciences And Medicines

Volume/Edition: 8

Language: English

Pages: 142 - 148

Abstract

Background: Outbreak of yellow fever infection (YFI), a mosquito-borne
disease, occurs sporadically worldwide especially in tropical nations. Acute
kidney injury (AKI) commonly results from YFI and could be associated with
a poor prognosis for victims even under intensive care unit (ICU). Pathophysiologic
mechanisms for AKI include hypovolemic shut down, cytotoxicity,
acute tubular necrosis (ATN), hemolysis, or coagulopathy. Early diagnosis,
prompt and effective treatment modalities including dialysis improve treatment
outcome. Aim: We report the case management of a 19-year-old woman
who had yellow fever infection complicated by acute kidney injury in the
setting of multi-organ dysfunction syndrome (MODS). Case Presentation: A
19-year-old woman who presented with fever, headache and vomiting for 2
weeks. In the course of the illness, urine volume became reduced and coke
colored, followed by body swelling, yellowness of the eyes bleeding from the
orifices. Examination revealed an acutely ill looking woman, icteric, and with
pedal edema. Her pulse was 100/min and blood pressure was 120/80 mmHg.
Liver was enlarged, soft and tender. She had proteinuria 3+ and polymerase
chain reaction (PCR) confirmed yellow fever infection. She had markedly deranged
serum biochemical parameters for which she had a three-hour session
of hemodialysis with Heparin anticoagulation. The urea reduction ratio
(URR) was 46.9%. Barrier nursing was commenced. She had 7 units of whole
blood and a pint of fresh frozen plasma (FFP) with antibiotics, Rabeprazole,
Tranexamic acid, Vitamin K and Frusemide. She had the second dialysis ses-


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