Internal medicine
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A 61-year-old woman who had been taking olmesartan for 7 years complained of epigastric pain, diarrhea, loss of appetite, and weight loss. Esophagogastroduodenoscopy revealed roughened mucosa and erosions in the stomach and duodenum. An endoscopic biopsy failed to identify the cause of the mucosal disorder. ⋯ After the discontinuation of olmesartan, the symptoms and gastric mucosal findings improved. A final diagnosis of olmesartan-associated gastritis was confirmed. Olmesartan-associated gastritis should be considered in patients taking olmesartan for upper gastrointestinal symptoms.
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A 45-year-old woman with Mycobacterium abscessus pulmonary disease was treated with multidrug therapy, including clofazimine, at Fukujuji Hospital. Six months after clofazimine initiation, the treatment was discontinued at the patient's request due to hyperpigmentation. ⋯ The patient's skin tone score closely correlated with the serum concentration of clofazimine. However, 14 months after the discontinuation of clofazimine, clofazimine-induced pigmentation was still not completely resolved.
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Changes in Hepatic Density Due to Oral Amiodarone-induced Liver injury Shown by Computed Tomography.
Amiodarone is an antiarrhythmic drug that is widely used for atrial fibrillation and other refractory arrhythmias. Although beneficial, its long-term administration is associated with adverse effects on various organs. One patient presented with amiodarone-induced liver injury, which led to liver failure. ⋯ Despite the discontinuation of the drug, the patient developed hepatic encephalopathy and subsequently died. This outcome highlights the drug's extended half-life, which caused persistent end-organ damage even after its withdrawal. Drug titration to the lowest effective dose and careful monitoring of annual liver function tests are important.
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Pseudomonas otitidis bacteremia is rare. We herein report a case of bacteremia caused by P. otitidis in a patient with advanced appendiceal cancer. A 79-year-old Japanese man developed infection when he was admitted to our hospital for palliative care. ⋯ Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry was used to identify the organism accurately. The patient was treated with a two-week course of piperacillin/tazobactam, and the bacteremia was successfully controlled. Clinicians should be aware that P. otitidis can cause bacteremia, particularly in immunocompromised patients.
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Nodal Epstein-Barr virus-positive T/NK-cell lymphoma (EB-nTNKL) is an extremely rare disease characterized by an aggressive clinical course and poor prognosis, for which treatment strategies have not yet been established. We herein report a young man with EB-nTNKL. Although initial chemotherapies, including L-asparaginase, failed to produce a good response, subsequent myeloablative allogeneic hematopoietic stem cell transplantation (alloHSCT) resulted in favorable disease control and a long-term disease-free survival. The prompt performance of alloHSCT using an available donor source at that time, regardless of whether or not the initial chemotherapy was effective, could be critical to saving patients with this otherwise fatal disease.