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
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Title
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
Subject
Acute respiratory distress syndrome, Disseminated intravascular coagulation, Septic shock, Acute kidney
injury, Purpura fulminans, Pasteurella multocida
injury, Purpura fulminans, Pasteurella multocida
Description
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.
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.
Creator
Aya Fukuhara*
, Seiko Fushimi, Masatoshi Nakata and Jumpei Takamatsu
, Seiko Fushimi, Masatoshi Nakata and Jumpei Takamatsu
Source
https://doi.org/10.1186/s12245-023-00493-1
Date
2023
Contributor
peri irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Aya Fukuhara*
, Seiko Fushimi, Masatoshi Nakata and Jumpei Takamatsu, “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,” Repository Horizon University Indonesia, accessed April 27, 2026, https://repository.horizon.ac.id/items/show/12123.