Nakano Mayuri, Yoshida Seiji, Nakayama Tadashi, Ogushi Fumitaka, Hanibuchi Masaki, Nishioka Yasuhiko
Kansenshogaku Zasshi. 2015 May;89(3):416-21. doi: 10.11150/kansenshogakuzasshi.89.416.
A 51-year-old man was admitted to our hospital because of fever and diarrhea. Chest X-ray revealed consolidation in the left lower lung field. Ceftriaxone and minocycline were given empirically, under the suspicion of bacterial or atypical pneumonia. In spite of treatment with antibiotics, the disease rapidly progressed to systemic inflammatory response syndrome. The diagnosis of acute respiratory distress syndrome (ARDS) accompanied with influenza (H1N1) 2009 was made because of positive findings of real-time polymerase chain reaction. While multidisciplinary treatment was performed, his condition was further deteriorated suggesting the excessive pro-inflammatory mediators. To remove them, we conducted polymyxin-B immobilized column-direct hemoperfusion (PMX-DHP), and his general condition recovered successfully. PMX-DHP may be a useful treatment choice for ARDS accompanied with influenza.
一名51岁男性因发热和腹泻入院。胸部X线显示左下肺野实变。在怀疑为细菌性或非典型肺炎的情况下，经验性给予头孢曲松和米诺环素。尽管使用了抗生素治疗，但疾病迅速进展为全身炎症反应综合征。由于实时聚合酶链反应结果呈阳性，诊断为2009年甲型H1N1流感伴急性呼吸窘迫综合征（ARDS）。在进行多学科治疗时，他的病情进一步恶化，提示促炎介质过多。为了清除这些介质，我们进行了多粘菌素B固定柱直接血液灌流（PMX-DHP），他的一般状况成功恢复。PMX-DHP可能是治疗甲型H1N1流感伴ARDS的一种有效治疗选择。
