Severe septic shock after injection to treat shoulder pain at a clinic near home

septic shock - Photo 1.

Doctor of Tropical Diseases Hospital examines patient - Photo: BVCC

About 10 days before being hospitalized, Ms. X. experienced pain in her right shoulder joint and went to a clinic near her home to have medication injected directly into the joint.

However, the symptoms did not improve and the pain increased. She then switched to acupuncture treatment but her condition continued to worsen, with a high fever and swelling of her entire shoulder spreading down her right arm.

The local medical facility diagnosed her with a soft tissue abscess, suspected to be caused by a bacterial infection. Despite antibiotics, her condition did not improve; her blood pressure dropped and she had to be kept on vasopressors to maintain her blood pressure.

Due to the critical situation, Ms. X. was transferred to the emergency department of the Central Hospital for Tropical Diseases.

At the time of admission, Ms. X. was completely dependent on vasopressors to maintain her blood pressure - a sign of severe, life-threatening septic shock. When blood pressure drops sharply, it causes insufficient blood to nourish organs such as the liver, kidneys, and heart, leading to a very high risk of multiple organ failure. Clinical examination showed that the entire right shoulder and arm were red, swollen, and painful.

Ultrasound and CT scan results showed diffuse subcutaneous inflammation in the arm area, accompanied by shoulder bursitis. No other sites of infection were detected, confirming that the injection site was the only route of entry causing septic shock.

Laboratory tests reflect severe systemic inflammation.

Ms. X. was treated actively with broad-spectrum antibiotics, medical resuscitation, and intensive care. After a few days, her blood pressure stabilized, the dose of vasopressors was gradually reduced, her fever and swelling improved significantly, and inflammation indicators decreased significantly.

Doctor Truong Tu The Bao - emergency department, Central Hospital for Tropical Diseases - said this is a typical case of the serious consequences of joint injection at a facility that does not ensure sterility.

The needle is a direct route of entry, if not sterile, bacteria can penetrate soft tissue, causing inflammation, blood infection and death if not treated promptly. For the elderly, with weak immune systems, the risk of severe infection is even higher.

This patient's case is a clear demonstration of the life-threatening risks from a seemingly simple procedure.

"People should go to a hospital or licensed medical facility when they need an injection, IV, or acupuncture. After the injection, if unusual signs such as increased pain, fever, swelling, or low blood pressure appear, they should go to a specialized medical facility as soon as possible for timely treatment to avoid unfortunate consequences," Dr. Bao advised.