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Systemic capillary leak syndrome presenting as recurrent shock.
[systemic capillary leak syndrome]
To
report
a
case
of
systemic
capillary
leak
syndrome
(
SCLS
)
in
a
child
.
Case
report
.
Pediatric
intensive
care
unit
.
A
6
-
yr
-old
girl
was
admitted
twice
to
the
pediatric
intensive
care
unit
,
at
a
10
-
month
interval
,
in
severe
shock
with
important
edema
.
The
patient
presented
with
acute
symptoms
of
abdominal
pain
,
vomiting
,
and
syncope
in
the
hour
preceding
the
shock
.
During
both
episodes
necessary
management
included
aggressive
intravenous
fluid
rehydration
,
mechanical
ventilation
,
and
use
of
inotropes
/
vasopressors
.
Suspicion
of
a
lower
limb
fasciitis
necessitated
surgical
exploration
,
but
pathology
reports
were
negative
on
both
occasions
revealing
only
subcutaneous
tissue
edema
.
The
patient
recovered
within
24
hrs
on
both
episodes
.
Investigation
ruled
out
cardiogenic
shock
and
septic
shock
due
to
bacterial
etiology
.
On
the
first
episode
,
a
nasopharyngeal
aspirate
was
positive
for
influenza
A
(
H
3
N
2
)
by
both
viral
immunofluorescence
and
culture
.
The
presumed
diagnosis
was
toxic
shock
syndrome
associated
with
influenza
virus
.
On
the
second
episode
,
all
bacterial
and
virology
cultures
remained
negative
.
Hypovolemic
shock
was
suspected
,
but
there
was
no
history
of
dehydration
,
bleeding
,
or
gastrointestinal
losses
(
persistent
vomiting
or
diarrhea
)
.
Noninfectious
causes
of
hypovolemic
shock
with
edema
were
ruled
out
,
leading
us
to
believe
that
she
suffered
from
SCLS
.
Although
well
described
in
the
adult
literature
,
there
have
been
few
reports
of
SCLS
in
pediatric
patients
.
SCLS
should
be
considered
in
the
differential
diagnosis
of
recurrent
hypovolemic
shock
without
identifiable
cause
.
The
only
therapeutic
intervention
is
to
obtain
vascular
access
when
initial
manifestations
occur
and
give
aggressive
fluid
reanimation
.
Diseases
Validation
Diseases presenting
"severe shock"
symptom
systemic capillary leak syndrome
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