書誌事項
- タイトル別名
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- Toxic shock-like syndrome(TSLS) due to group G .BETA.-streptococcus in a patient on chronic maintenance hemodialysis
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A 38-year-old male with diabetic nephropathy on maintenance hemodialysis (HD) for 1 and half years was admitted to our hospital with complaints of nausea and vomiting, high fever, generalized muscle pain and hypotension. Blood test showed increased serum CK, myoglobin, CRP, and WBC, with mild liver damage. The blood culture was positive for group G β-streptococcus. CT, MRI and gallium scintigraphy showed retention of knee joint fluid, myolysis of the skeletal muscle and soft tissue inflammation. The clinical manifestations in this patient along with the laboratory findings were compatible with the diagnostic criteria for TSLS proposed by the centers for disease control (CDC) in the USA.<br>Immediately after admission, he was aggressively treated with antibiotics and immunoglobulin, and blood purification with CHDF and hemoadsorption were started. He responded to treatment and survived without surgical resection of the affected lesions.<br>To our knowledge, this is the first case of TSLS caused by group G streptococcus in a patient on maintenance HD. The mortality and morbidity of TSLS is high; thus physicians must remain alert for early recognition of this disease and early introduction of blood purification treatment. The literature concerning TSLS due to nongroup A streptococci was reviewed.
収録刊行物
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- 日本透析医学会雑誌
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日本透析医学会雑誌 37 (8), 1651-1657, 2004
一般社団法人 日本透析医学会
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詳細情報 詳細情報について
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- CRID
- 1390001204674190464
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- NII論文ID
- 130003875278
- 10013515139
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- NII書誌ID
- AN10432053
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- ISSN
- 1883082X
- 13403451
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- 本文言語コード
- ja
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- データソース種別
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- JaLC
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- 抄録ライセンスフラグ
- 使用不可