Kansenshōgaku zasshi. The Journal of the Japanese Association for Infectious Diseases
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Procalcitonin (PCT) was initially described as a calcitonin prohormone and later shown to be a useful marker for identifying bacterial infection and sepsis. We evaluated PCT's clinical efficacy in assessing bacterial infection severity, measuring PCT and systemic inflammatory response syndrome (SIRS) markers in 180 subjects with suspected infection. PCT titer was higher with increasing infection severity. PCT was thus useful in identifying those in critical condition.
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Kansenshogaku Zasshi · Nov 2009
Case Reports[An autopsy case involving severe sepsis due to Capnocytophaga canimorsus infection].
Capnocytophaga canimorsus, a commensal bacterium from the carine mouth, causes septicemia in human beings through bites or scratches. We report a case of a 60-year-old man contracting septicemia due to C. canimorsus infection after a dog bite who died less than 12 hours after admission. We observed neutrophils with intracytoplasmic bacilli in the peripheral blood smear. We discuss clinical presentation and autopsy findings.
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Kansenshogaku Zasshi · Jul 2009
Case Reports[An autopsy case of fulminant community-acquired pneumonia due to Acinetobacter baumannii].
A 73-year-old man with underlying chronic renal failure, angina pectoris, chronic heart failure, and respiratory failure reporting three-day appetite loss, fever, and drowsiness was admitted for lower right lung pneumonia. Despite antibiotic administration, infiltration progressed to the entire right lung and upper left lung after 12 hours, and he developed acute respiratory distress syndrome (ARDS) and multiple organ failure. Respirator ventilation and continuous hemodiafiltration (CHDF) failed to halt this progression and he died on hospital day 3. ⋯ This is, to our knowledge, the first report in Japan. In the subtropical zone, A. baumannii is recognized as an important cause of severe community-acquired pneumonia. Given the apparent progress of global warming, physicians in Japan would do well to familiarize themselves with subtropical disease causes such A. baumannii when managing severe community-acquired pneumonia.
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Kansenshogaku Zasshi · Oct 2005
Case Reports[A case of nonclostridial gas gangrene of the leg complicated by severe pneumonia].
A 73-year-old man admitted for febrile left leg pain with dyspnea, who had poorly controlled diabetes was found on admission to have severe hypoxia and chest X-ray showed infiltrates in the middle to lower left lung. X-rays of the left leg showed gas around the knee joint. These findings suggested severe pneumonia with gas gangrene, necessitating immediate debridement of the gas gangrene lesion and hyperbaric oxygenation. ⋯ Gas gangrene was considered the primary infection followed by pneumonia, since pain and swelling of the left leg preceded the airway symptoms. The present case illustrates in compromised hosts including diabetics, gas gangrene may develop taking an opportunity of airway infection, and that in some cases, early debridement of the lesion and optimal use of antibiotics may help cure this disease without aggressive surgery. Hyperbaric oxygenation may also be useful, although its validity must be investigated further.
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Kansenshogaku Zasshi · Aug 2005
Case Reports[Generalized tetanus with intractable autonomic cardiovascular instability in an aged woman].
Tetanus is characterized by tetanic convulsions related to the actions of tetanospasmin produced by Clostridium tetani. Another important characteristic of tetanus is the instability of the cardiovascular system related to sympathetic hyperactivity in the autonomic nervous system, and it may be an important prognostic factor. We report a patient with tetanus in whose unstable circulatory kinetics made circulation management difficult. ⋯ Because of the unstable circulatory kinetics, the patient was carefully managed was performed in the intensive care unit (ICU), and she improved. ICU management may be essential for treating severe tetanus with cardiovascular complications. Acquired immunity is not achieved after the onset of tetanus, and since elderly people, in particular, as in our own caset, are easily injured when they fall, we recommend vaccination.