title: Septic neonate rescued by polymyxin B hemoperfusion.
abstract: Sepsis caused by group B streptococcus has been well controlled with aminobenzylpenicillin, but the incidence of Escherichia coli sepsis has increased in proportion. E. coli is a Gram-negative bacillus associated with poor prognosis due to the release of endotoxins. Conventional treatment with antibiotics alone may not be sufficient because the inflammatory response exacerbates the unstable hemodynamic status. Polymyxin B hemoperfusion has been established as a treatment option for septic shock in adults. Polymyxin B hemoperfusion adsorbs endotoxins and cannabinoids such as anandamide and 2-arachidonoylglycerol. Reported herein is a case of severe septic shock induced by E. coli. The concomitant use of polymyxin B hemoperfusion rapidly reduced the requirement for catecholamines and the patient was discharged without short-term neurological or respiratory sequelae. It is suggested that polymyxin B hemoperfusion might be an innovative therapy for severe sepsis, and could improve outcome.
authors.affiliation: Division of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima, Japan. nicuhirakawa@gmail.com
authors.forename: Eiji
authors.initials: E
authors.lastname: Hirakawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ibara
authors.forename: Takuya
authors.initials: T
authors.lastname: Tokuhisa
authors.forename: Sayuri
authors.initials: S
authors.lastname: Hiwatashi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Hayashida
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Maede
authors.forename: Takako
authors.initials: T
authors.lastname: Matsui
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Nakazawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Inoue
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kodaira
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000188:drug therapy*; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006464:Hemoperfusion; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008471:Meconium Aspiration Syndrome / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D010547:Persistent Fetal Circulation Syndrome / Q000175:diagnosis / Q000188:drug therapy; D011112:Polymyxin B / Q000008:administration & dosage*; D012772:Shock, Septic / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D011112:Polymyxin B