The Benefit of Telemonitoring in the Prevention of Septic Shock in a Patient with Aggressive Non-Hodgkin’s Lymphoma

Abstract

Telemonitoring is a great tool for vital signs monitoring in patients at high risk of severe life-threatening infections, such as haemato-oncological patients. As it can detect early symptoms of an infection, it allows early reaction and, therefore, can help prevent the progression of the infection into severe sepsis. We present a case report of a 69-year-old patient with aggressive non-Hodgkin lymphoma undergoing intensive immunochemotherapy. The treatment was complicated by two episodes of Gram-negative bacterial (G−) infection. During the first episode, the patient was admitted to the hospital only after developing septic shock with multiorgan dysfunction syndrome, which required vasopressor support and multiple broad-spectrum antibiotics and other antimicrobial therapy. Following this episode, the patient was enrolled in our telemonitoring project focusing on early detection of infections in high-risk haemato-oncological patients. The patient later developed another infection with G− bacteremia; however, thanks to the telemonitoring, he was admitted to the hospital within a few hours after developing (and detecting) fever. The therapy was initiated immediately, and the infection was successfully managed with first-choice antibiotics without any further complications. This case illustrates the importance of early detection of infection in high-risk patients, as well as the benefits of telemonitoring. Moreover, avoidance of septic shock and the consequent need for intensive care can significantly reduce healthcare costs.

Keywords

• telemedicine
• febrile neutropenia
• septic shock
• non-hodgkin lymphoma