Internal medicine
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Infection with Aeromonas species has been reported to occur in neutropenic patients. Necrotizing fasciitis caused by Aeromonas species is uncommon but potentially life-threatening. We herein describe three cases of fulminant necrotizing fasciitis caused by Aeromonas sobria in neutropenic patients. ⋯ Our experience suggests that necrotizing fasciitis caused by Aeromonas sobria is a distinctive and fatal entity. As the use of quinolones is not usually considered in cases of febrile neutropenia, it is important to adjust the antibiotics in time when culture results become available. In some cases, early treatment with quinolones and surgical intervention should be considered, especially when this complication occurs in patients with profound neutropenia.
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Behçet's disease is a chronic relapsing disease with multiple organ system involvement, including the gastrointestinal tract, which is known as intestinal Behçet's disease. Intestinal Behçet's disease is often resistant to empirical treatments such as 5-aminosalicylic acid, immunomodulators and steroids and often causes a perforation, requiring surgical resection. Therefore, intestinal lesions are considered to be a poor prognostic factor in Behçet's disease. ⋯ We herein report the case of an adult female patient with intestinal Behçet's disease who responded well to the induction therapy with infliximab, and has been maintained in remission by scheduled administration of infliximab. Her C-reactive protein level has been sustained at a negative level, and endoscopic findings revealed complete mucosal healing. Therefore, infliximab may have the potential to induce "sustained deep remission" in patients with intestinal Behçet's disease.
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An enlarged left atrium (LA) has recently been identified as a risk factor for adverse cardiovascular outcomes in various pathologic conditions. However, few studies have evaluated its prognostic value in hemodialysis (HD) patients. ⋯ The results of the present study suggested that measurement of LAVI may be helpful in the risk stratification of HD patients and in providing therapeutic direction for their management.
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Case Reports
Pulmonary tumor embolism secondary to uterine corpus carcinosarcoma mimicking pulmonary thromboembolism.
We herein report a case of pulmonary tumor embolism caused by hematogenous metastasis that mimicked pulmonary thromboembolism in a 62-year-old Japanese woman with a history of uterine corpus carcinosarcoma. The case suggests that tumor embolism must be included in the differential diagnoses of respiratory symptoms in patients with a history of malignancy. It also illustrates the usefulness of such findings as beaded, dilated pulmonary arteries by computed tomography (CT) and high (18)F-fluorodeoxyglucose (FDG) uptake by fusion FDG positron emission tomography/CT imaging for differentiating a pulmonary tumor embolism from pulmonary thromboembolism.
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To evaluate the incidence and risk factors for malignancy in Japanese patients with systemic sclerosis (SSc). ⋯ Lung cancer was significantly frequent in SSc patients, which could develop on the basis of complicated ILD.