Abstract
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.
