From Kidney Crisis to Heart Revival: A Case of Septic Cardiomyopathy Following Septic Shock Induced by Xanthogranulomatous Pyelonephritis

Septic cardiomyopathy (SCM) is a reversible cardiac dysfunction occurring in patients with sepsis or septic shock, characterized by transient impaired myocardial contractility. Despite its prevalence in severe sepsis and significant impact on patient outcomes, SCM remains underdiagnosed and is one of the least studied forms of cardiomyopathy. Its recognition and management are further complicated by the absence of a universally accepted consensus on its diagnostic criteria and definition. We report the case of a 54-year-old female presenting with septic shock secondary to xanthogranulomatous pyelonephritis (XGP). The patient presented with acute right lower back pain, fever, and hemodynamic instability. Initial echocardiography assessment demonstrated a preserved left ventricular ejection fraction (LVEF), which subsequently deteriorated following the onset of septic cardiomyopathy. Early recognition and management, including the use of vasopressors, inotropes, and judicious fluid resuscitation, resulted in full recovery of cardiac function within one week. This case highlights the importance of clinical vigilance and prompt intervention in the management of SCM, particularly in cases complicating severe infections such as XGP.