{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T23:34:42Z","timestamp":1784158482222,"version":"3.55.0"},"reference-count":10,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2016,11,1]],"date-time":"2016-11-01T00:00:00Z","timestamp":1477958400000},"content-version":"vor","delay-in-days":31,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2016,10]]},"abstract":"Abstract<\/jats:title>Toxic shock syndrome (TSS<\/jats:styled-content>) is a critical illness associated with toxin from Staphylococcus aureus<\/jats:italic>. Despite recent advances in critical care, mortality remains high and additional effective therapy is required. We report an adolescent case of TSS<\/jats:styled-content> successfully treated with direct hemoperfusion using polymyxin\u2010B immobilized fiber (PMX<\/jats:styled-content>\u2010DHP<\/jats:styled-content>). The patient with spina bifida also had ischial pressure ulcer, and developed TSS<\/jats:styled-content> associated with methicillin\u2010resistant S.\u00a0aureus<\/jats:italic>. Despite conventional treatment, the patient developed refractory shock, which was immediately improved with PMX<\/jats:styled-content>\u2010DHP<\/jats:styled-content>. PMX<\/jats:styled-content>\u2010DHP<\/jats:styled-content> has been widely used for the treatment of sepsis to remove circulating endotoxins produced by Gram\u2010negative bacteria, but beneficial effects have also been reported for Gram\u2010positive bacterial infection. To our knowledge, this is the first report on PMX<\/jats:styled-content>\u2010DHP<\/jats:styled-content> for TSS<\/jats:styled-content> in an adolescent patient, and we propose that PMX<\/jats:styled-content>\u2010DHP<\/jats:styled-content> could be a new treatment strategy for severe TSS<\/jats:styled-content> in children as well.<\/jats:p>","DOI":"10.1111\/ped.13087","type":"journal-article","created":{"date-parts":[[2016,11,2]],"date-time":"2016-11-02T01:14:43Z","timestamp":1478049283000},"page":"1051-1054","source":"Crossref","is-referenced-by-count":9,"title":["Polymyxin\u2010B immobilized column\u2013direct hemoperfusion for adolescent toxic shock syndrome"],"prefix":"10.1111","volume":"58","author":[{"given":"Etsuro","family":"Nanishi","sequence":"first","affiliation":[{"name":"Department of Pediatrics Graduate School of Medical Sciences Kyushu University Fukuoka Japan"},{"name":"Emergency and Critical Care Center Kyushu University Hospital Fukuoka 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