EJMCR |

Case Series

Volume: 5 | Issue: 9 | Published: Oct 19, 2021 | Pages: 260 - 264 | DOI: 10.24911/ejmcr/173-1615055105

Spontaneous muscle hematomas presenting with hemorrhagic shock in critically ill patients with SARSCoV- 2 pneumonia

Authors: Diana Zamudio , Guillermo Egea , Sara G. Zamorano

Article Info

Authors

Diana Zamudio

Department of Anesthesiology and Critical Care, Alcorcon Foundation University Hospital, Madrid, Spain

ORCID

Guillermo Egea

Department of Anesthesiology and Critical Care, Alcorcon Foundation University Hospital, Madrid, Spain

Sara G. Zamorano

Department of Anesthesiology and Critical Care, Alcorcon Foundation University Hospital, Madrid, Spain.

Publication History

Received: March 07, 2021

Accepted:

Published: October 19, 2021

Abstract

Background: Spontaneous muscle hematomas (SMH) are rare but potentially life-threatening. We report three patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia who developed hemorrhagic shock, due to large SMHs, during their intensive care unit stay. Case Presentation: All the patients were receiving mechanical ventilation and anticoagulation therapy with enoxaparin. The bleeding was located in the gluteal muscles in two of the patients and in the iliopsoas muscle with retroperitoneal extension in the other. Anemia and hemodynamic instability were the main signs; however, because of their gradual onset, they were initially confused with the anemia of the critically ill patient and sepsis related to secondary infections. All received conservative medical treatment, but unfortunately one patient died within hours of diagnosis. Conclusion: This report highlights that clinicians should also be alert to major spontaneous hemorrhage in patients with SARSCoV- 2 infection. Since it is a novel disease, a possible association with bleeding events cannot be disregarded and, on the contrary, should be considered, particularly to determine the appropriate use of anticoagulation in this type of patients.

Keywords: Coronavirus, COVID-19, SARS-CoV-2, muscle hematomas, hemorrhagic shock, retroperitoneal bleeding, green

Pubmed Style

Diana Zamudio, Guillermo Egea, Sara G. Zamorano. Spontaneous muscle hematomas presenting with hemorrhagic shock in critically ill patients with SARSCoV- 2 pneumonia. EJMCR. 2021; 19 (October 2021): 260-264. doi:10.24911/ejmcr/173-1615055105

Web Style

Diana Zamudio, Guillermo Egea, Sara G. Zamorano. Spontaneous muscle hematomas presenting with hemorrhagic shock in critically ill patients with SARSCoV- 2 pneumonia. https://ejmcr.com/articles/1121 [Access: December 25, 2024]. doi:10.24911/ejmcr/173-1615055105

AMA (American Medical Association) Style

Vancouver/ICMJE Style

Diana Zamudio, Guillermo Egea, Sara G. Zamorano. Spontaneous muscle hematomas presenting with hemorrhagic shock in critically ill patients with SARSCoV- 2 pneumonia. EJMCR. (2021), [cited December 25, 2024]; 19 (October 2021): 260-264. doi:10.24911/ejmcr/173-1615055105

Harvard Style

Diana Zamudio, Guillermo Egea, Sara G. Zamorano (2021) Spontaneous muscle hematomas presenting with hemorrhagic shock in critically ill patients with SARSCoV- 2 pneumonia. EJMCR, 19 (October 2021): 260-264. doi:10.24911/ejmcr/173-1615055105

Chicago Style

Diana Zamudio, Guillermo Egea, Sara G. Zamorano. "Spontaneous muscle hematomas presenting with hemorrhagic shock in critically ill patients with SARSCoV- 2 pneumonia." 19 (2021), 260-264. doi:10.24911/ejmcr/173-1615055105

MLA (The Modern Language Association) Style

Diana Zamudio, Guillermo Egea, Sara G. Zamorano. "Spontaneous muscle hematomas presenting with hemorrhagic shock in critically ill patients with SARSCoV- 2 pneumonia." 19.October 2021 (2021), 260-264. Print. doi:10.24911/ejmcr/173-1615055105

APA (American Psychological Association) Style

Diana Zamudio, Guillermo Egea, Sara G. Zamorano (2021) Spontaneous muscle hematomas presenting with hemorrhagic shock in critically ill patients with SARSCoV- 2 pneumonia. , 19 (October 2021), 260-264. doi:10.24911/ejmcr/173-1615055105