Septic shock caused by Streptococcus pneumoniae in a post-splenectomy patient successfully treated with recombinant human activated protein C.
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.
Schumann
Christian
C
Department of Internal Medicine II, University of Ulm, Germany. christian.schumann@medizin.uni-ulm.de
Triantafilou
Kathy
K
Kamenz
Joachim
J
Hanke
Hartmut
H
Triantafilou
Martha
M
Wittemann
Silke
S
Joos
Thomas
T
Hombach
Vinzenz
V
Schneider
E Marion
EM
Lepper
Philipp M
PM
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
D011486:Protein C; D011994:Recombinant Proteins; C421124:drotrecogin alfa activated