EpistemisProstration due to physical decay
Specialty: General.
Why it occurs
- Severe systemic bacterial or viral infections in the stage phase (septicemia, bilateral lobar pneumonia, subacute decompensated endocarditis)
- Acute adrenal insufficiency or Addison's crisis (glucocorticoid deficiency that nullifies the body's ability to respond to stress, causing hemodynamic and muscular collapse)
- Myasthenia gravis in myasthenic crisis or progressive Guillain-Barré syndrome (loss of neuromuscular innervation that prevents standing)
- Severe hydroelectrolyte imbalances (extreme hyponatremia, severe hypokalemia or tumor hypercalcemia that interfere with cellular contractility)
- Advanced malignant neoplasms with massive cerebral or systemic involvement that consume the body's metabolic reserve.
Initial workup
Immediate hospital admission for monitoring: arterial and venous blood gases, serum electrolytes (sodium, potassium, ionic calcium, magnesium, phosphorus), emergency serum cortisol, serial blood cultures, urine culture, 12-lead electrocardiogram, and emergency brain computed tomography.
red flags
Presence of difficulty maintaining airway patency, respiratory dyspnea with intercostal indrawing, severe arterial hypotension refractory to oral hydration, altered state of consciousness or coma.
Standard management
- Hydrocortisone — 100 mg intravenously immediately in suspected adrenal crisis
- Physiological solution of Sodium Chloride at 0.9% — controlled intravenous infusion to restore peripheral circulatory volume and correct hypotension
- Symptomatic support with oxygen therapy through nasal prongs or mask if there is documented hypoxia (saturation <90%).
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- General
- Listed causes
- 5
- Treatment options
- 3