PMID- 36894896
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230311
IS  - 1865-1372 (Print)
IS  - 1865-1380 (Electronic)
IS  - 1865-1372 (Linking)
VI  - 16
IP  - 1
DP  - 2023 Mar 9
TI  - Venoarterial extracorporeal membrane oxygenation treatment for acute respiratory 
      distress syndrome and non-occlusive mesenteric ischemia due to Pasteurella 
      multocida-related sepsis with purpura fulminans: a case report.
PG  - 17
LID - 10.1186/s12245-023-00493-1 [doi]
LID - 17
AB  - BACKGROUND: Pasteurella multocida-related sepsis can cause purpura fulminans 
      (PF), a rare thrombotic disorder that often presents acutely and is potentially 
      fatal. As a consequence of disseminated intravascular coagulation, this 
      hematological emergency originates from micro-thrombotic occlusion of peripheral 
      blood vessels and resulting circulatory failure. Thus far, no studies have 
      reported the use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) 
      for saving lives in patients with worsening respiratory and circulatory failure. 
      Moreover, the development of non-occlusive mesenteric ischemia after VA-ECMO has 
      not yet been documented. Here, we describe the case of a 52-year-old female 
      patient with PF and non-occlusive mesenteric ischemia due to Pasteurella 
      multocida-related sepsis who received VA-ECMO. CASE PRESENTATION: A 
      52-year-old-female patient presented to the hospital with a week-long fever and 
      worsening cough. Chest radiography findings revealed ground-glass opacity. We 
      made a diagnosis of acute respiratory distress syndrome due to sepsis and 
      initiated ventilatory management. Because respiratory and circulatory parameters 
      were not maintained, VA-ECMO was introduced. After admission, ischemic findings 
      were observed in the periphery of the extremities, and a diagnosis of PF was 
      made. Pasteurella multocida was detected in blood cultures. On day 9, the sepsis 
      was cured with antimicrobial treatment. The patient's respiratory and circulatory 
      status improved, and she was weaned off VA-ECMO. However, on day 16, her stable 
      circulatory system collapsed again, and her abdominal pain worsened. We performed 
      exploratory laparotomy and noted necrosis and perforation of the small intestine. 
      As a result, partial resection of the small intestine was performed. CONCLUSION: 
      In this case, VA-ECMO was used to maintain circulatory dynamics during septic 
      shock in a patient with Pasteurella multocida infection who developed PF. Surgery 
      was also performed for complicated ischemic necrosis of the intestinal tract, 
      helping save the patient's life. This development illustrated the importance of 
      paying attention to intestinal ischemia during intensive care.
CI  - (c) 2023. The Author(s).
FAU - Fukuhara, Aya
AU  - Fukuhara A
AD  - Department of Emergency Medicine and Critical Care, Kansai Rosai Hospital, 
      3-1-69, Inabaso, Amagasaki, Hyogo, Japan. shaonkai1023@yahoo.co.jp.
FAU - Fushimi, Seiko
AU  - Fushimi S
AD  - Department of Emergency Medicine and Critical Care, Kansai Rosai Hospital, 
      3-1-69, Inabaso, Amagasaki, Hyogo, Japan.
FAU - Nakata, Masatoshi
AU  - Nakata M
AD  - Department of Emergency Medicine and Critical Care, Kansai Rosai Hospital, 
      3-1-69, Inabaso, Amagasaki, Hyogo, Japan.
FAU - Takamatsu, Jumpei
AU  - Takamatsu J
AD  - Department of Emergency Medicine and Critical Care, Kansai Rosai Hospital, 
      3-1-69, Inabaso, Amagasaki, Hyogo, Japan.
LA  - eng
PT  - Journal Article
DEP - 20230309
PL  - England
TA  - Int J Emerg Med
JT  - International journal of emergency medicine
JID - 101469435
PMC - PMC9996852
OTO - NOTNLM
OT  - Acute kidney injury
OT  - Acute respiratory distress syndrome
OT  - Disseminated intravascular coagulation
OT  - Pasteurella multocida
OT  - Purpura fulminans
OT  - Septic shock
COIS- The authors declare that they have no competing interests.
EDAT- 2023/03/10 06:00
MHDA- 2023/03/10 06:01
PMCR- 2023/03/09
CRDT- 2023/03/09 23:34
PHST- 2022/06/29 00:00 [received]
PHST- 2023/03/02 00:00 [accepted]
PHST- 2023/03/09 23:34 [entrez]
PHST- 2023/03/10 06:00 [pubmed]
PHST- 2023/03/10 06:01 [medline]
PHST- 2023/03/09 00:00 [pmc-release]
AID - 10.1186/s12245-023-00493-1 [pii]
AID - 493 [pii]
AID - 10.1186/s12245-023-00493-1 [doi]
PST - epublish
SO  - Int J Emerg Med. 2023 Mar 9;16(1):17. doi: 10.1186/s12245-023-00493-1.