A 48 year-old Cambodian patient fell into a deep coma and the acute respiratory distress syndrome because of the undesirable side effects of the common drugs used in the treatment of fever.

Presented at CIH 5:00 am on February 14, 2019, Mr. Oum Sokun, 48 years old  was in deep coma, with acute respiratory failure due to lung injury, ventilator assisted, body swelling, no Urine, intermittent hemorrhage on the body with severe skin necrosis which is marked redness (erythema) of the skin, burning pain and swelling.

Painful red or purple skin that looks burned and peels off

His family members said that before being admitted to CIH 5 days, Mr. Sokun started to have a cold which made him feverish/chills, headaches and fatigue. Then he went to the local pharmacy to buy some pills for a common cold. Few hours later, he felt a burning pain, shortness of breath, severe skin rash, body swelling. He was taken to emergency department at a hospital in Cambodia. Here the patient has been assisted by mechanical ventilation because of severe respiratory failure.

 After 5 days of treatment, the disease got worsen and worsen, his relatives sent patients to City International Hospital through the program of medical cooperation between City Plus and Khema Clinic Medical Center in Phnom Penh.

The emergency multidisciplinary approach including Active Resuscitation specialists, Artificial Kidneys, Dermatology, Inner Neurology and Cardiology to view synthesizing medical history, thorough clinical examination, necessary blood tests and diagnostic imaging, City Plus Medical Council Severe sepsis with Stevens Johnson syndrome which caused by drug induced. The disease has progressed to multi-organ damage including coma due to central nervous system damage, severe acute renal failure, conjunctivitis, inflammatory spread of 2 lung infections infected with emphysema, subcutaneous emphysema chest wall, cardiac enzymes suspected due to myocarditis, elevated liver enzymes due to hepatocellular injury, gastrointestinal hemorrhage due to diffuse gastrointestinal mucosal damage, decreased 3 blood cell lines due to bone marrow damage, collapse coagulation function.

CIH's Intensive Care Team, Patient and family. 

Identifying a life-threatening serious condition, Intensivists have immediately implemented comprehensive emergency treatments. Patient was put undermechanical ventilation, emergency dialysis, blood transfusions and blood products during hemodialysis. Numerous specific therapies for Stenvens-Johnson syndrome as well as other supportive therapies have been used throughout the nearly 3-month treatment period in Active Care. The patient was treated with corticosteroids, antibiotics to treat pneumonia according to antimicrobial, positive gastrointestinal (GI) and intravenous nutrition, support liver function, injectable drugs to stimulate red blood cell growth and leukocytes, blood transfusions and blood products of many episodes, hemostatic GI endoscopy to treat GI bleeding, open the trachea to the skin, practice positive physiotherapy, take care of skin lesions and eye…

A great challenge for the expert team at City International Hospital during treatment is a very high allergic allergy to most drugs including antibiotics, analgesic, anti-inflammatory, antipyretic and antipyretic both with milk and some nutritious foods. The Patient and doctors faced repeated recurring ventilator-related pneumonia with multidrug-resistant bacteria based on lung fibrosis and emphysema. The duration of dependent breathing machines has lasted more than 2 months. There have been devastating phases that experts had to put through; "taking humanity and wisdom" has been repeatedly playing in our heads anytime facing the patient’s critical conditions and explaining to his family.

After a long 97-day-long  course of treatment at CIH’s intensive care unit, patients gradually recovered. Renal function improved completely after 3 weeks of active hemodialysis. the patient with greater adherence (4+ days/week) to walking and light exposure. Along with better nutritional status, good control of infection, respiratory function gradually recovered, the patient was stopped from mechanical ventilation after 2 months. On May 14, 2019, after withdrawing the trachea tube, patients breathe well through the nose, eating well through the mouth, can sit up in bed. Currently, the patient has been transferred to the Department of Surgery to continue care and treatment

Congrats to CIH's medical team and good wishes to the patient and families and continue to Enjoy a good quality of life.

Dr. Dao Thi My Van - Deputy Medical Director, Head of ICU,, City Plus program founder shared: "Stevens-Johnson Syndrome (Stevens-Johnson Syndrome, SJS) Stevens–Johnson syndrome (SJS) is a type of severe skin reaction. Together with toxic epidermal necrolysis (TEN) and Stevens-Johnson/toxic epidermal necrolysis (SJS/TEN), it forms a spectrum of disease, with SJS being less severe. Early symptoms of SJS include fever and flu-like symptoms. 

Stevens-Johnson syndrome is a medical emergency that usually requires hospitalization. Treatment focuses on eliminating the underlying cause, controlling symptoms and minimizing complications as your skin regrows. Recovery after Stevens-Johnson syndrome can take weeks to months, depending on the severity of your condition. If it was caused by a medication, you'll need to permanently avoid that drug and others closely related to it."

City International Hospital’s City Plus Program 

If you or your doctor would like a second opinion…. City Plus’s world class Medical Second Opinion program brings you Closest to the Cure. When you or your loved ones are diagnosed with a serious medical condition, you want the best medical advice from the country’s best hospital and top physicians. City Plus offers better quality of expert diagnosis help patients feel comfortable compared to the initial diagnosis. We utilize a collaborative and holistic medical review by our multidisciplinary team of expert physicians from all over the country, not just a single physician review; City Plus provides medical information and recommendations from expert physicians who practice at City International Hospital (CIH). City Plus’s premiere service offering, a remote medical second opinion (MSO) service provides our users the option of having their diagnosis and/or treatment plan evaluated by some of the top medical minds in the region, allowing them access to the most up to date clinical information available on almost any medical condition. CIH is renowned for leading the hospital in cutting-edge non-surgical and surgical treatments, and overall quality of clinical outcomes. Our Members do not have to travel or deal with healthcare systems, CIH’s City Plus brings answers and peace of mind to them. All it takes is a phone call to get started. Contact City Plus consulting hotline: (+84) 286 280 3333 (Press 0 and talk to the operator.)

  City International Hospital

• Add: No. 3, 17A Street, Binh Tri Dong B Ward, Binh Tan Dist. (Next to AEON Mall Binh Tan), HCM City.
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