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- Title
ZAPALENIE PŁUC O ETIOLOGII LEGIONELLA PNEUMOPHILA LECZONE W ODDZIALE INTENSYWNEJ TERAPII Z ZASTOSOWANIEM POZAUSTROJOWEJ ELIMINACJI ENDOTOKSYN.
- Authors
KUPIEC, ANNA; GUZIŃSKI, MACIEJ; CHALASIEWICZ, AGATA; ADAMIK, BARBARA; DUSZYŃSKA, WIESŁAWA
- Abstract
It was presented a case report of a 62-year-old man diagnosed with legionellosis. The severe clinical condition and subsequent development of septic shock required hospitalization in the ICU; the patient required vasopressors at a dose of 0.07-0.3 pg/kg/min and mechanical ventilatory support (PaO2/FiO2 - 124.3; sat - 88%). Empirical antibiotic therapy with ceftriaxone and clarithromycin was started immediately after admission to the ICU. Legionella pneumophila serotype 1 antigen was detected in the urine on the second day of treatment. Due to the acute kidney injury and high endotoxin activity in the blood, continuous veno- venous haemodiafiltration (CVVHDF) with extracorporeal endotoxin elimination was induced (oXiris™). The blood endotoxins activity decreased from 0.67 EAU (endotoxin activity units) to 0.37 EAU after 24 hours. Early identification of the pathogen, accurate antibiotic treatment, and standard management of septic shock supported by extracorporeal endotoxin elimination led to recovery; after 22 days of treatment the patient in good clinical condition was transferred to another ward.
- Publication
Forum Zakażeń, 2015, Vol 6, Issue 1, p401
- ISSN
2082-0623
- Publication type
Article
- DOI
10.15374/FZ2014069