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首页> 美国卫生研究院文献>Respiratory Medicine Case Reports >Successful treatment of sepsis due to Pantoea agglomerans by polymyxin B-immobilized fiber column direct hemoperfusion therapy in a small cell lung carcinoma patient
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Successful treatment of sepsis due to Pantoea agglomerans by polymyxin B-immobilized fiber column direct hemoperfusion therapy in a small cell lung carcinoma patient

机译：多黏菌素B固定化纤维柱直接血液灌流治疗小细胞肺癌患者成功治疗全团聚脓毒症

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摘要

Sepsis is a life-threatening condition caused by the inflammatory response to invading organisms. Polymyxin B-immobilized fiber column direct hemoperfusion (PMX-DHP) is used to reduce blood endotoxin levels and modulate circulating inflammatory cytokine levels in sepsis patients. Here we report that severe sepsis caused by an infection of the gram-negative bacterium Pantoea agglomerans in a patient with small cell lung carcinoma was treated successfully with antibiotics and PMX-DHP. The patient, a 49-year-old Japanese male smoker whose condition was complicated with hyponatremia due to SIADH (syndrome of inappropriate secretion of antidiuretic hormone), rapidly developed sepsis and disseminated intravascular coagulation (DIC) after the administration of cisplatin and irinotecan. Despite initial antibiotics therapy, severe host responses including hypotension, high body temperature and tachycardia were noted. We initiated PMX-DHP, and the patient's Sequential Organ Failure Assessment score was greatly reduced and his DIC improved immediately. To our knowledge, this is the first reported case of PMX-DHP therapy for severe sepsis caused by P. agglomerans infection. Although the efficacy of PMX-DHP in sepsis is not well defined, PMX-DHP therapy should be considered in cases of sepsis from gram-negative infections.
机译：败血症是由对入侵生物的炎性反应引起的危及生命的疾病。固定有多粘菌素B的纤维柱直接血液灌注（PMX-DHP）用于降低败血症患者的血液内毒素水平并调节循环炎症细胞因子水平。在这里，我们报告说，在小细胞肺癌患者中，革兰氏阴性菌Pantoea agloglomerans感染引起的严重败血症已成功通过抗生素和PMX-DHP治疗。该患者是一名49岁的日本男性吸烟者，其病情因SIADH（抗利尿激素分泌不当综合征）而并发低钠血症，在顺铂和伊立替康给药后迅速发展为败血症并弥散性血管内凝血（DIC）。尽管开始使用抗生素治疗，但仍注意到严重的宿主反应，包括低血压，体温升高和心动过速。我们启动了PMX-DHP，患者的顺序器官衰竭评估得分大大降低，而DIC立即得到改善。据我们所知，这是第一例报道的PMX-DHP治疗严重凝集性脓毒症感染病例。尽管尚不清楚PMX-DHP在脓毒症中的疗效，但在革兰氏阴性感染引​​起的脓毒症病例中应考虑PMX-DHP治疗。

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