title: Septic shock caused by Streptococcus pneumoniae in a post-splenectomy patient successfully treated with recombinant human activated protein C.
abstract: We present a case of severe sepsis due to Streptococcus pneumoniae, serotype 22F treated with recombinant human activated protein C (drotrecogin alpha activated) (DrotAA). APACHE II score at admission was 34 with a predicted mortality of 81%. A wide range of cytokines, chemokines and receptors was measured before and after DrotAA treatment. Soon after infusion of 24 microg DrotAA per kg bodyweight and h (microg/kg/h) over a period of 96 h, cytokine levels fell markedly. The patient survived and was discharged after 6 weeks of hospitalization. In conclusion, administration of DrotAA in a case of Streptococcus pneumoniae-induced septic shock was followed by dramatic changes in serum levels of immuno-regulatory cytokines.
authors.affiliation: Department of Internal Medicine II, University of Ulm, Germany. christian.schumann@medizin.uni-ulm.de
authors.forename: Christian
authors.initials: C
authors.lastname: Schumann
authors.forename: Kathy
authors.initials: K
authors.lastname: Triantafilou
authors.forename: Joachim
authors.initials: J
authors.lastname: Kamenz
authors.forename: Hartmut
authors.initials: H
authors.lastname: Hanke
authors.forename: Martha
authors.initials: M
authors.lastname: Triantafilou
authors.forename: Silke
authors.initials: S
authors.lastname: Wittemann
authors.forename: Thomas
authors.initials: T
authors.lastname: Joos
authors.forename: Vinzenz
authors.initials: V
authors.lastname: Hombach
authors.forename: E Marion
authors.initials: EM
authors.lastname: Schneider
authors.forename: Philipp M
authors.initials: PM
authors.lastname: Lepper
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D011008:Pneumococcal Infections / Q000188:drug therapy*; D011486:Protein C / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use; D012772:Shock, Septic / Q000188:drug therapy / Q000382:microbiology*; D013156:Splenectomy; D013296:Streptococcus pneumoniae / Q000302:isolation & purification / Q000472:pathogenicity
chemical_list: D011486:Protein C; D011994:Recombinant Proteins; C421124:drotrecogin alfa activated