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Plasmapheresis for Rescue in Severe Encephalopathy and Multiorgan Failure from Fulminant Influenza (H3N2) Infection

Prashant Jha1,2, Daniel Gebhard3,4

  • 1From the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Children's Hospital of Nevada at University Medical Center, Las Vegas, NV.

The Pediatric Infectious Disease Journal
|September 14, 2020
PubMed

Insights

A previously healthy child developed coma and multiorgan failure during influenza. Plasmapheresis, targeting immune-mediated causes, led to rapid recovery and discharge.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Influenza infections can rarely present with severe systemic complications beyond respiratory symptoms.
  • Acute hepatitis and multiorgan failure in children necessitate prompt diagnosis and intervention.

Observation:

  • A 4-year-old previously healthy male presented with coma, severe acute hepatitis, and multiorgan failure.
  • The presentation occurred in the context of an active influenza infection.

Findings:

  • Literature review suggested an immune-mediated pathophysiology for this severe presentation.
  • Plasmapheresis was initiated as a therapeutic trial based on the suspected immune mechanism.

Implications:

  • Successful plasmapheresis resulted in rapid clinical improvement and full neurological recovery.
  • This case highlights plasmapheresis as a potential treatment for influenza-associated multiorgan failure with immune-mediated etiology.

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