A case of fulminant pseudomembranous colitis leading to cardiac arrest

DOI 9 References Open Access
  • Fujizuka Kenji
    Department of Emergency and Critical Care Medicine, Japan Red Cross Maebashi Hospital
  • Nakano Minoru
    Department of Emergency and Critical Care Medicine, Japan Red Cross Maebashi Hospital
  • Otsuka Osamu
    Department of Medical Gastroenterology, Japan Red Cross Maebashi Hospital
  • Takahashi Eiji
    Department of Emergency and Critical Care Medicine, Japan Red Cross Maebashi Hospital
  • Nakamura Mitsunobu
    Department of Emergency and Critical Care Medicine, Japan Red Cross Maebashi Hospital
  • Miyazaki Dai
    Department of Emergency and Critical Care Medicine, Japan Red Cross Maebashi Hospital
  • Ogura Takayuki
    Department of Emergency and Critical Care Medicine, Japan Red Cross Maebashi Hospital
  • Harasawa Tomofumi
    Department of Emergency and Critical Care Medicine, Japan Red Cross Maebashi Hospital

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Other Title
  • 劇症型偽膜性腸炎による心肺停止を救命した一例

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A 64-year-old, woman was prescribed antibiotics at a hospital for a common cold 5 days and 2 weeks before being transferred to our hospital because of her poor general condition. We administered early goal-directed therapy and the steroids owing to septic shock. However, she experienced cardiopulmonary arrest and was resuscitated. On the basis of the colonoscopy findings and positive test results for Clostridium difficile toxin, we diagnosed the patient with fulminant pseudomembranous colitis (PMC). Because surgical therapy is difficult under sever septic conditions, we decided to administer conservative treatment. We initiated direct hemoperfusion using a polymyxin B immobilized fiber column direct hemoperfusion (PMX-DHP), and reduced the dose of catecholamines, we discontinued catecholamines by day 3. Her general condition stabilized, and she was discharged from the ICU on day 16, and from the hospital, on day 86. Fulminant PMC has a high mortality rate, and many patients experience treatment failure despite surgical treatment. We successfully managed fulminant PMC with conservative treatment under appropriate circulation management and PMX-DHP.

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