Seraph Microbind filter used in a 7-year-old with refractory septic shock and invasive Streptococcus pyogenes infection

$Seraph Microbind filter used in a 7-year-old with refractory septic shock and invasive Streptococcus…$

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Frontiers in Medicine Published April 18, 2026 Medically reviewed April 25, 2026 DOI ↗ By Dr. Sofia Müller, MD · Lifespan & Whole-Person Care

Key Takeaway

Note potential adjunctive rescue role of hemoperfusion in refractory septic shock, but recognize severe ischemia risks and inability to establish causality.

A single case report from pediatric intensive care units details the use of Seraph Microbind 100 Microbind affinity blood filter in a previously healthy 7-year-old girl. The patient presented with refractory septic shock, streptococcal toxic shock syndrome, and invasive Streptococcus pyogenes infection. Standard therapy included broad-spectrum antibiotics, immunoglobulins, vasopressors, mechanical ventilation, and continuous renal replacement therapy.

The intervention involved the Seraph Microbind 100 Microbind affinity blood filter (pathogen-binding hemoperfusion). Main results showed progressive reduction in vasoactive support and improvement in metabolic parameters. The patient did not require venous-arterial extracorporeal membrane oxygenation and survived the clinical course. However, early severe peripheral ischemia occurred, leading to bilateral lower-limb amputations.

Safety concerns included early severe peripheral ischemia resulting in bilateral lower-limb amputations. Discontinuations were not reported, and tolerability was not reported. Key limitations include the inability to establish causality, the single-case nature of the report, and circuit instability requiring a stand-alone session. The study phase and publication type were not reported.

Practice relevance suggests a potential role for hemoperfusion as an adjunctive rescue therapy in selected cases. Causality cannot be established, and optimal timing, clinical efficacy in pediatric populations, and safety remain uncertain based on this evidence.

Study Details

Study typeCohort

EvidenceLevel 3

PublishedApr 2026

View Original Abstract ↓

BackgroundSeptic shock remains a major cause of morbidity and mortality in pediatric intensive care units, particularly in refractory cases unresponsive to standard therapy. Invasive Streptococcus pyogenes infection can lead to streptococcal toxic shock syndrome, characterized by severe inflammatory dysregulation and rapid clinical deterioration. Extracorporeal blood purification therapies, such as pathogen-binding hemoperfusion, have emerged as potential adjunctive treatments.Case PresentationWe report the compassionate use of the Seraph® 100 Microbind® affinity blood filter in a previously healthy 7-year-old girl with refractory septic shock caused by invasive S. pyogenes. Despite early initiation of broad-spectrum antibiotics, immunoglobulins, vasopressors, mechanical ventilation, and continuous renal replacement therapy, the patient developed severe multiorgan dysfunction and persistent hemodynamic instability. Hemoperfusion was initiated 42 h after pediatric intensive care unit admission. Due to circuit instability, treatment was performed as a stand-alone 4-h session. Following hemoperfusion, a progressive reduction in vasoactive support and improvement in metabolic parameters, including lactate clearance, were observed within 24–48 h. The patient stabilized without requiring veno-arterial extracorporeal membrane oxygenation. However, early severe peripheral ischemia led to bilateral lower-limb amputations. The patient survived and was discharged after prolonged hospitalization.ConclusionIn this case, pathogen-binding hemoperfusion with the Seraph® 100 filter was technically feasible and temporally associated with hemodynamic and metabolic improvement in refractory pediatric septic shock. Although causality cannot be established, these findings suggest a potential role for hemoperfusion as an adjunctive rescue therapy in selected cases. Further prospective studies are needed to determine its safety, optimal timing, and clinical efficacy in pediatric populations.