Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.06.021
Brazilian Journal of Anesthesiology
Case Report

Immunoadsorption therapy for a meningococcemia patient with myocarditis, adrenal hemorrhage, and purpura fulminans: a case report

Nihal Akcay; Hasan Serdar Kihtir; Guner Ozcelik; Ulkem Kocoglu Barlas; Mey Talip Petmezci; Esra Sevketoglu

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Abstract

Neisseria meningitidis, also known as meningococcus, is a relatively uncommon cause of invasive infection, but when it occurs, it is frequently severe and potentially life-threatening. A ten-year-old female patient developed a purpuric rash with fever. Upon arrival to the pediatric intensive care department, she was unconscious and in a poor general condition. We combined treatment with antibiotics, volume resuscitation, hydrocortisone, and CytoSorb® therapy resulted in a stabilization of hemodynamics, as well as control of hyperinflammation. We observed a significant decrease in vasopressor dosage in this patient.

Keywords

Myocarditis; Purpura Fulminans; Plasmapheresis; Waterhouse-Friderichsen Syndrome

References

1 K.S. Kim Acute bacterial meningitis in infants and children Lancet Infect Dis, 10 (2010), pp. 32-42

2 J.A. Siddiqui, M.A. Ameer, P.G. Gulick Meningococcemia. [Updated 2020 Oct 3] StatPearls [Internet], StatPearls Publishing, Treasure Island (FL) (2020) Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534849/

3 A.R. de Caen, M.D. Berg, L. Chameides, et al. Part 12: Pediatric Advanced Life Support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Circulation, 132 (2015), pp. S526-42

4 K.W.E. Hilarius, P.W. Skippen, N. Kissoon Early Recognition and Emergency Treatment of Sepsis and Septic Shock in Children Pediatr Emerg Care., 36 (2020), pp. 101-106

5 K. Kogelmann, D. Jarczak, M. Scheller, et al. Hemoadsorption by CytoSorb in septic patients: a case series Crit Care., 21 (2017), p. 74

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