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Unresponsive to therapy: case report In a study of 23 patients, an 83-year-old woman was described, who exhibited unresponsiveness to epinephrine and norepinephrine, indicated for septic shock. The woman, who had underlying diabetes and osteoporosis, had a pertrochanteric fracture. Eight months previously, she had undergone implantation of gamma nail. She presented to the emergency department with pain. The implant was compromised with malpositioned nail, having no signs of callus. Additionally, multiple sacral sores were noted. Of note, clinical signs of shoulder arthritis were evident. The affected thigh was 12cm larger in diameter, associated with redness. The nail was subjected to surgical debridement. The following day (day of surgery), she was in a semicomatose state. During surgery, an extremely large quantity of pus was extracted, and during the same night, she went into septic shock with high potassium levels and anuria. She was unresponsive to norepinephrine and epinephrine [dosages and routes not stated]. The same night, she died of septic shock. Dragosloveanu S, et al. A new perspective towards failure of gamma nail systems. Experimental and Therapeutic Medicine 20: 216, No. 1, Dec 2020. Available from: URL: 803520541 http://doi.org/10.3892/ETM.2020.9346

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Reactions 12 Dec 2020 No. 1834