Abstract
A high proportion of the patients with Salmonella enterica serotype Typhi infection develop severe sepsis. The mortality rate is high despite aggressive antimicrobial therapy in these patients. The case of a 10-year-old boy who developed thrombocytopenia-associated multiple organ failure (TAMOF) secondary to S. typhi infection is reported. The patient did not respond to antimicrobial treatment, including ciprofloxacin, in addition to conventional supportive measures, so plasma exchange was performed. The thrombocytopenia and organ failure had resolved after 3 days of plasma exchange therapy. Plasma exchange is suggested to be a life-saving intervention in a child with TAMOF secondary to S. typhi infection.
Highlights
Severe sepsis is a frequent reason for hospitalization and mortality in children
Previous studies investigating the improvement of outcome in sepsis have concentrated on the correction of organ dysfunction, it has been shown that systemic thrombosis and thrombocytopenia were the key factors in the prognosis of the cases [6]
We report on a child without any underlying disease who developed S. typhi septicemia, presenting with Thrombocytopenia-associated multiple organ failure (TAMOF) and treated with plasma exchange
Summary
Severe sepsis is a frequent reason for hospitalization and mortality in children. Septic shock has a high mortality risk at approximately 63%, and if multiple organ dysfunction syndrome (MODS) develops the mortality increases to approximately 80% [1,2,3]. Bacteremia caused by S. typhi is reported to have a benign clinical course, previous studies investigating the improvement of outcome in sepsis have concentrated on the correction of organ dysfunction, it has been shown that systemic thrombosis and thrombocytopenia were the key factors in the prognosis of the cases [6]. Many forms of multiple organ failure have been identified to be associated with thrombocytopenia and systemic thrombosis at autopsy series This thrombotic storm situation causes mortality in cases with sepsis, despite new treatment modalities. Thrombocytopenia-associated multiple organ failure (TAMOF) is a thrombotic microangiopathic syndrome that has been reported in critically ill patients. After infection, transplantation, radiation, chemotherapy, autoimmune diseases, and cardiopulmonary bypass [5] It is defined by the clinical triad of newonset thrombocytopenia, multiple organ failure, and increased lactate dehydrogenase (LDH) levels. We report on a child without any underlying disease who developed S. typhi septicemia, presenting with TAMOF and treated with plasma exchange
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