Raziuddin Ahmed
Square Hospitals Ltd, BangladeshPresentation Title:
Effective management of voriconazole-induced multi-organ dysfunction and septic shock using Cytosorb-integrated continuous renal replacement therapy: A case report
Abstract
Background: Drug-induced multi-organ dysfunction remains a significant clinical challenge, especially when complicated by inflammatory cascades. Voriconazole (VRC) is a commonly used antifungal agent, but its administration can sometimes result in severe systemic toxicity. This case report describes the use of Continuous Renal Replacement Therapy (CRRT) combined with CytoSorb hemoadsorption for managing voriconazole-associated toxicity.
Case Presentation: A 34-year-old male developed gastrointestinal and respiratory symptoms, hypotension, and multi-organ dysfunction after two weeks of oral VRC for tinea corporis. His condition worsened with septic shock, requiring ICU admission. Laboratory tests revealed Acute Kidney Injury (AKI) and cardiac impairment. CRRT with CytoSorb was initiated to reduce the inflammatory burden. The patient also required SLED and multiple transfusions.
Management and Outcome: CytoSorb therapy was added to the CRRT circuit to target the suspected cytokine-driven inflammatory response. Over time, the patient's hemodynamic and biochemical parameters improved. The intervention appeared to help control systemic inflammation, supporting organ function, and improving clinical stability.
Conclusion: This case highlights the potential role of CytoSorb hemoadsorption in combination with CRRT for managing drug-induced multi-organ dysfunction. While further studies are necessary, this case contributes to the growing interest in hemoadsorption as a supportive measure in critical care
Biography
Raziuddin
Ahmed graduated from Sir Salimullah Medical College (SSMC) and completed his
internship at Mitford Hospital. He then joined King Salman Hospital, Riyadh,
Saudi Arabia, one of the largest hospitals under the Ministry of Health (MOH). He further advanced his career by enrolling in the Saudi Board of Residency in
Internal Medicine. He later earned his MRCP in Internal Medicine from the Royal
College of Physicians, UK, and obtained the EDIC (European Diploma in Intensive
Care Medicine) from the European Society of Intensive Care Medicine (ESICM). He is a member of the Royal College
of Physicians Edinburgh. With 12 years of experience in Internal Medicine
and ICU in Saudi Arabia, he has gained
invaluable skills in managing critically ill patients. He has received advanced
training in the UK and Belgium and attended courses on ECMO in Singapore, Critical Care Ultrasound and ECHO in India, and mechanical ventilator and
hemodynamics training. Currently, he
serves as the co-ordinator and one of the official instructors for FCCS
(Fundamentals of Critical Care Support) in Bangladesh, approved by the Society
of Critical Care Medicine (SCCM), US. He is
an Associate Consultant in Internal & Critical Care Medicine at Square
Hospital.
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