Blood purification for treatment of non-liquefied multiple liver abscesses and improvement of T-cell function:A case report  

作　　者：Zhi-Qiang Tang Dan-Ping Zhao A-Jing Dong Hai-Bo Li 

机构地区：[1]Intensive Care Unit,The Second Affiliated Hospital of Harbin Medical University,Harbin 150001,Heilongjiang Province,China

出　　处：《World Journal of Clinical Cases》2023年第27期6515-6522,共8页世界临床病例杂志

摘　　要：BACKGROUND Non-liquefied multiple liver abscesses(NMLA)can induce sepsis,septic shock,sepsis-associated kidney injury(SA-AKI),and multiple organ failure.The inability to perform ultrasound-guided puncture and drainage to eradicate the primary disease may allow for the persistence of bacterial endotoxins and endogenous cytokines,exacerbating organ damage,and potentially causing immunosuppression and T-cell exhaustion.Therefore,the search for additional effective treatments that complement antibiotic therapy is of great importance.CASE SUMMARY A 45-year-old critically ill female patient presented to our hospital’s intensive care unit with intermittent vomiting,diarrhea,and decreased urine output.The patient exhibited a temperature of 37.8℃.Based on the results of liver ultrasonography,laboratory tests,fever,and oliguria,the patient was diagnosed with NMLA,sepsis,SA-AKI,and immunosuppression.We administered antibiotic therapy,entire care,continuous renal replacement therapy(CRRT)with an M100 hemofilter,and hemoperfusion(HP)with an HA380 hemofilter.The aforementioned treatment resulted in a substantial reduction in disease severity scores and a decrease in the extent of infection and inflammatory factors.In addition,the treatment stimulated the expansion of the cluster of differentiation 8^(+)(CD8^(+))Tcells and led to the complete recovery of renal function.The patient was discharged from the hospital.During the follow-up period of 28 d,she recovered successfully.CONCLUSION Based on the entire therapeutic regimen,the early combination of CRRT and HP therapy may control sepsis caused by NMLA and help control infections,reduce inflammatory responses,and improve CD8^(+)T-cell immune function.

关 键 词：Non-liquefied multiple liver abscesses Sepsis Acute kidney injury Continuous renal replacement therapy HEMOPERFUSION Case report 

分 类 号：R656[医药卫生—外科学]