{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T18:00:52Z","timestamp":1774375252610,"version":"3.50.1"},"reference-count":22,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,1,21]]},"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:p>Current therapies frequently used for refractory septic shock include hydrocortisone, vasopressin, extracorporeal membrane oxygenation (ECMO) support, inodilators, levosimendan and methylene blue. The evidence for these treatments is very limited. We present a case of a 5-year-old patient with refractory septic shock, secondary to <jats:italic>Listeria monocytogenes<\/jats:italic> meningitis. She presented with status epilepticus and developed septic shock. Shock persisted despite multiple high-dose vasoactive medications. ECMO support was not available. The medical team decided to use methylene blue to revert the vasoplegia, with excellent results. Shortly after the administration, vasopressors were weaned off and the high lactate cleared. She developed severe neurological sequelae due to brain haemorrhage secondary to the <jats:italic>Listeria<\/jats:italic> meningitis. The evidence supporting methylene blue for refractory septic shock in paediatric patients is limited. This case represents the effectiveness of this therapy without secondary effects.<\/jats:p>","DOI":"10.1136\/bcr-2021-243772","type":"journal-article","created":{"date-parts":[[2022,2,28]],"date-time":"2022-02-28T10:50:32Z","timestamp":1646045432000},"page":"e243772","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Methylene blue for the treatment of refractory septic shock secondary to listeriosis in a paediatric patient"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6141-6622","authenticated-orcid":false,"given":"Jes\u00fas Angel","family":"Dom\u00ednguez-Rojas","sequence":"first","affiliation":[{"name":"Deparment of Pediatrics, National Hospital Edgardo Rebagliati Martins, Lima, Peru"},{"name":"Deparment of Critical Care, Instituto Nacional De Salud Del Ni\u00f1o Bre\u00f1a, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Caqui","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hospital Nacional Hipolito Unanue, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abel","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hospital Nacional Hipolito Unanue, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5349-5260","authenticated-orcid":false,"given":"Alvaro J","family":"Coronado Munoz","sequence":"additional","affiliation":[{"name":"Deparment of Pediatrics, The University of Texas Health Science Center at Houston, Houston, Texas, 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