書誌事項
- タイトル別名
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- A Case of Influenza Pneumonia Following Pneumococcal Infection in an Adult Patient with Concurrent Encephalopathy with a Lesion in the Splenium of the Corpus Callosum
- 症例 肺炎球菌感染を併発したインフルエンザ肺炎に,脳梁膨大部病変を伴う脳症を合併した1成人例
- ショウレイ ハイエン キュウキン カンセン オ ヘイハツ シタ インフルエンザ ハイエン ニ,ノウリョウボウダイブ ビョウヘン オ トモナウ ノウショウ オ ガッペイ シタ 1 セイジンレイ
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A 35-year-old male patient had a fever, cough, and other symptoms since the end of December 2010. The patient then developed a high fever and decreased SPO2, suggesting possible pneumonia. The patient was admitted to our hospital on the 6th day of illness. Chest computed tomography revealed multiple infiltrative shadows and ground-glass opacities distributed in a patchy pattern in the bilateral lungs. An atypical pneumonia was suspected, and we initiated antibiotic treatment with minocycline. However, the patient developed consciousness disturbance in the afternoon of the 7th day of illness. The high fever persisted, suggesting the patientʼs poor response to minocycline treatment, which was then replaced with ciprofloxacin and imipenem/cilastatin on the 8th day of illness. Streptococcuspneumoniae was detected in the blood culture bottles submitted at the time of admission. A head magnetic resonance imaging performed on that day showed a high intensity area in the splenium of the corpus callosum, leading to a diagnosis of encephalopathy. Methylprednisolone pulse therapy and gamma globulin treatment were initiated. The patient then recovered consciousness gradually with improvement of inflammatory responses and imaging findings. Subsequently, an influenza virus (H1N1) antibody level was found to have increased from less than 10 times to 640 times. Thus, it was determined that the patientʼs pneumonia and encephalopathy were attributable to the influenza A (H1N1) pdm09 virus during the flu season and Streptcoccal infection. Combination therapy, such as steroid pulse treatment, appropriate antibiotics and gamma globulin preparation was effective for both the flu-induced mixed pneumonia and encephalopathy in this patient.
収録刊行物
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- 感染症学雑誌
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感染症学雑誌 87 (4), 451-456, 2013
一般社団法人 日本感染症学会
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詳細情報 詳細情報について
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- CRID
- 1390001205049581824
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- NII論文ID
- 10031201449
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- NII書誌ID
- AN00047715
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- ISSN
- 1884569X
- 03875911
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- NDL書誌ID
- 024820158
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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
- NDL
- Crossref
- CiNii Articles
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- 抄録ライセンスフラグ
- 使用不可