title: Polymyxin B-immobilized fiber hemoperfusion in a high school football player with septic shock caused by osteitis pubis.
abstract: A 17-year-old male high school football player treated by polymyxin B-immobilized fiber (PMX-F) hemoperfusion for mild-moderate septic shock caused by osteitis pubis is described in this study. He was admitted for inguinal pain, gait disturbance, and high fever (40.6°C). His white blood cell (WBC) count and C-reactive protein (CRP), endotoxin, and procalcitonin (PCT) levels were significantly elevated. His blood pressure was 76/46 mm Hg. Magnetic resonance imaging showed bone and muscle injury at the pubic symphysis. Septic shock with high blood endotoxin and PCT concentrations was diagnosed, and the patient was treated with antibiotics, γ-globulin, and dopamine on the admission day. However, the septic shock did not improve. On day 3, we performed direct hemoperfusion twice using a PMX-F column. After the second PMX-F treatment, the patient's temperature decreased to 37.0°C, and his WBC count, CRP levels, blood endotoxin, and PCT levels decreased. The inguinal pain diminished, and the patient's blood pressure increased to 112/76 mm Hg. He was discharged on day 10 after admission. This case reflects association of PMX-F with decreased endotoxin, PCT, and CRP, suggesting the association of PMX-F with clinical improvement in mild-moderate sepsis in a young athlete.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Shinmatsudo Central General Hospital, Chiba, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Nakamura
authors.forename: Eiichi
authors.initials: E
authors.lastname: Sato
authors.forename: Nobuharu
authors.initials: N
authors.lastname: Fujiwara
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kawagoe
authors.forename: Yoshinaga
authors.initials: Y
authors.lastname: Egawa
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Ueda
authors.forename: Hikaru
authors.initials: H
authors.lastname: Koide
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D056352:Athletes; D002097:C-Reactive Protein / Q000378:metabolism; D005538:Football; D006464:Hemoperfusion; D006801:Humans; D008297:Male; D010000:Osteitis / Q000628:therapy*; D010477:Perfusion; D011112:Polymyxin B / Q000494:pharmacology*; D018805:Sepsis; D012772:Shock, Septic / Q000628:therapy*; D013696:Temperature; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein; D011112:Polymyxin B