脾臓摘出22年後に発症した overwhelming postsplenectomy infection  [in Japanese] Overwhelming Postsplenectomy Infection 22 Years After Splenectomy  [in Japanese]

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Author(s)

    • 楠元 規生 KUSUMOTO Norio
    • 宮崎大学医学部内科学講座免疫感染病態学 Department of Rheumatology, Infectious diseases Medicine, Faculty of Medicine, University of Miyazaki
    • 黒木 昌幸 KUROKI Masayuki
    • 宮崎大学医学部内科学講座免疫感染病態学 Department of Rheumatology, Infectious diseases Medicine, Faculty of Medicine, University of Miyazaki
    • 梅北 邦彦 [他] UMEKITA Kunihiko
    • 宮崎大学医学部内科学講座免疫感染病態学 Department of Rheumatology, Infectious diseases Medicine, Faculty of Medicine, University of Miyazaki
    • 上野 史朗 UENO Shiro
    • 宮崎大学医学部内科学講座免疫感染病態学 Department of Rheumatology, Infectious diseases Medicine, Faculty of Medicine, University of Miyazaki
    • 高城 一郎 TAKAJO Ichiro
    • 宮崎大学医学部内科学講座免疫感染病態学 Department of Rheumatology, Infectious diseases Medicine, Faculty of Medicine, University of Miyazaki
    • 甲斐 泰文 KAI Yasufumi
    • 宮崎大学医学部内科学講座免疫感染病態学 Department of Rheumatology, Infectious diseases Medicine, Faculty of Medicine, University of Miyazaki
    • 長友 安弘 NAGATOMO Yasuhiro
    • 宮崎大学医学部内科学講座免疫感染病態学 Department of Rheumatology, Infectious diseases Medicine, Faculty of Medicine, University of Miyazaki
    • 島田 雅己 SHIMADA Masami
    • 宮崎大学医学部附属病院検査部 Department of Labolatory Medicine, Faculty of Medicine, University of Miyazaki
    • 日高 智徳 HIDAKA Tomonori
    • 国立病院機構都城病院内科 Department of Internal Medicine, National Hospital Organization Miyakonojou National Hospital
    • 久保 和義 KUBO Kazuyoshi
    • 宮崎大学医学部内科学講座免疫感染病態学 Department of Rheumatology, Infectious diseases Medicine, Faculty of Medicine, University of Miyazaki
    • 宮内 俊一 MIYAUCHI Syunnichi
    • 宮崎大学医学部内科学講座免疫感染病態学 Department of Rheumatology, Infectious diseases Medicine, Faculty of Medicine, University of Miyazaki
    • 岡山 昭彦 OKAYAMA Akihiko
    • 宮崎大学医学部内科学講座免疫感染病態学 Department of Rheumatology, Infectious diseases Medicine, Faculty of Medicine, University of Miyazaki

Abstract

A 25-year-old man undergoing splenectomy at 3 years of age to treat idiopathic thrombocytopenic purpura but no history of <i>Streptococcus pneumonia</i> vaccination, and reporting high fever, nausea, and headache developed purpura, confusion, and hypotension the next day and was admitted. Detailed examination showed disseminated intravascular coagulation and multiple-organ dysfunction. Chest X-ray and computed tomography (CT) showed pneumonia and pleural effusion. Blood culture was positive for <i>S. pneumoniae</i>. Gram staining of sputa yielded numerous white blood cells and gram-negative rods, and sputa culture was positive for <i>Pasteurella multocida</i> and <i>Haemophilus influenzae</i>. The medical history and presence of these organisms yielded a diagnosis of overwhelming postsplenectomy infection (OPSI), and the patient responded to treatment with a combination of benzylpenicillin, cefotaxime, and meropenem. This case suggests that patients with a history of splenectomy may benefit from vaccination for <i>S. pneumoniae</i> and adequate education on OPSI.

Journal

  • Kansenshogaku Zasshi

    Kansenshogaku Zasshi 83(3), 261-265, 2009-05-20

    The Japanese Association for Infectious Diseases

References:  16

Cited by:  4

Codes

  • NII Article ID (NAID)
    10024803643
  • NII NACSIS-CAT ID (NCID)
    AN00047715
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03875911
  • NDL Article ID
    10320867
  • NDL Source Classification
    ZS9(科学技術--医学--病理学・微生物学・寄生虫学・感染・免疫学・血清学・アレルギー)
  • NDL Call No.
    Z19-193
  • Data Source
    CJP  CJPref  NDL  J-STAGE 
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