Plasmapheresis has been used to treat sepsis associated with necrotizing soft tissue infections. Supplemental use of intravenous immunoglobulin (IVIg) also has been beneficial in patients with sepsis who are immunocompromised. This case report describes the adjunctive use of plasmapheresis and IVIg therapy in the treatment of a woman who had a fluid-filled sac in both lower quadrants of the abdomen, indicating infection and bowel perforation.
In the United States, approximately 750 000 cases of severe sepsis occur each year, and more than 210000 cases result in death.1,2 Although the prevalence of sepsis continues to increase, the mortality rate of 28% to 50% remains unchanged.1,2 Sepsis causes disturbances of homeostasis that lead to excessive coagulation, systemic inflammation, and impaired fibrinolysis.3 In addition, blood flow to organs can be reduced despite adequate cardiac output because an imbalance occurs between coagulation and fibrinolysis, resulting in impaired tissue perfusion....