下咽頭癌の化学放射線併用療法中に発症したアメーバ赤痢症例

DOI Web Site Web Site 被引用文献2件 参考文献1件

書誌事項

タイトル別名
  • A Case of Amebic Dysentery During Concurrent Chemoradiotherapy for Hypopharyngeal Cancer
  • 臨床 下咽頭癌の化学放射線併用療法中に発症したアメーバ赤痢症例
  • リンショウ カイントウ ガン ノ カガク ホウシャセン ヘイヨウ リョウホウ チュウ ニ ハッショウ シタ アメーバ セキリ ショウレイ

この論文をさがす

抄録

We report a case of amebic dysentery during combination chemoradiotherapy for hypopharyngeal cancer. The patient was a 52-year-old man with suspected hypopharyngeal cancer who was referred by his local physician after presenting with pharyngeal pain. The results of detailed investigations, including CT, showed hypopharyngeal cancer (T2N0M0), and the patient was admitted for simultaneous radiotherapy and S-1 plus nedaplatin (hereafter, SN therapy). On hospital day 36 (on day 6 after the second course of SN was started), 10 episodes of mucous, bloody stools and diarrhea were observed on the same day, accompanied by a left lower abdominal pain. We performed a lower gastrointestinal endoscopy that revealed aphthous ulcers from the ascending colon to the lower rectum. The biopsy showed numerous trophozoites consuming red blood cells, leading to a diagnosis of amebic dysentery. The patient was given oral metronidazole (1 g/day) for 10 days, and the symptoms improved. After treatment, a lower gastrointestinal endoscopy showed that the ulceration had disappeared and that the mucosa appeared normal. In this case, we believe that amebic dysentery occurred because of the patient’s background of decreased immune function caused by the administration of chemotherapy and steroids. Mucous, bloody stools and diarrhea during chemotherapy should lead to concerns not only of an adverse chemotherapy event causing gastrointestinal mucosal edema and ulceration, but also of an opportunistic infection and amebic dysentery. In the present case, early diagnosis by a skilled doctor was an important factor; the disease might have become more severe if the diagnosis had not been reached. For this reason, obtaining a sufficient history as well as performing a lower gastrointestinal endoscopy and biopsy are important for early diagnosis.

収録刊行物

被引用文献 (2)*注記

もっと見る

参考文献 (1)*注記

もっと見る

キーワード

詳細情報 詳細情報について

問題の指摘

ページトップへ