Demons syndrome with pericardial effusion followed by intensive care unit-acquired weakness: A case report and literature review

Abstract

Demons syndrome is defined by hydrothorax and ascites associated with a benign genital tumor that resolves after resection of the tumor. However, Demons syndrome with pericardial effusion has never been reported. Intensive care unit–acquired weakness is a neurological sequela to sepsis/systemic inflammatory response syndrome, or multi-organ failure. A 47-year-old, nulligravid, Japanese woman, was transferred to our hospital for refractory heart failure and a ruptured ovarian tumor. She had an 11-cm left ovarian tumor with ascites, hydrothorax, and pericardial effusion; she was intubated for pulmonary hypertension and admitted to the intensive care unit for septic shock. Four days later, a left salpingo-oophorectomy was performed for Demons syndrome with pericardial effusion. The histological diagnosis indicated a serous cystadenoma with fibrotic changes. Following surgery, ventilator weaning was delayed due to intensive care unit–acquired weakness. The association between Demons syndrome and pericardial effusion should be recognized to ensure early treatment and for preventing sequalae from the disease.

Undiagnosed myotonic dystrophy: A case report and literature review

“…Several factors can cause an imbalance between respiratory muscle strength and the workload of breathing, resulting in weaning difficulties in the ICU. These factors comprise respiratory or ventilatory, cardiac, psychological, ventilator circuit-related and nutritional issues (8,10). a summary of the reported cases of MD1 diagnosed following post-operative weaning failure is presented in table I (11)(12)(13)(14).…”

“…In a previous multicenter, prospective study of patients in the intensive care unit (ICU), the incidence rate of difficult-to-wean cases was found to be 39% of the patients who received mechanical ventilation for at least 12 h (7). Patients in this category should be identified for etiologies, such as respiratory, cardiac, psychological, ventilator circuit and nutritional issues, as well as ICU-acquired weakness (8). this workup process can sometimes be difficult if the disease etiology is unknown.…”