論文

査読有り 国際誌
2018年10月19日

Purpura fulminans with Lemierre's syndrome caused by Gemella bergeri and Eikenella corrodens: a case report.

BMC infectious diseases
  • Toshinobu Yamagishi
  • Mayu Hikone
  • Kazuhiro Sugiyama
  • Takahiro Tanabe
  • Yasuhiro Wada
  • Michiko Furugaito
  • Yuko Arai
  • Yutaka Uzawa
  • Ryo Mizushima
  • Keisuke Kamada
  • Yasutomo Itakura
  • Shigekazu Iguchi
  • Atsushi Yoshida
  • Ken Kikuchi
  • Yuichi Hamabe
  • 全て表示

18
1
開始ページ
523
終了ページ
523
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1186/s12879-018-3437-6

BACKGROUND: Gemella bergeri is one of the nine species of the genus Gemella and is relatively difficult to identify. We herein describe the first case of septic shock due to a Gemella bergeri coinfection with Eikenella corrodens. CASE PRESENTATION: A 44-year-old Asian man with a medical history of IgG4-related ophthalmic disease who was prescribed corticosteroids (prednisolone) presented to our hospital with dyspnea. On arrival, he was in shock, and a purpuric eruption was noted on both legs. Contrast enhanced computed tomography showed fluid retention at the right maxillary sinus, left lung ground glass opacity, and bilateral lung irregular opacities without cavitation. Owing to suspected septic shock, fluid resuscitation and a high dose of vasopressors were started. In addition, meropenem, clindamycin, and vancomycin were administered. Repeat computed tomography confirmed left internal jugular and vertebral vein thrombosis. Following this, the patient was diagnosed with Lemierre's syndrome. Furthermore, he went into shock again on day 6 of hospitalization. Additional soft tissue infections were suspected; therefore, bilateral below the knee amputations were performed for source control. Cultures of the exudates from skin lesions and histopathological samples did not identify any pathogens, and histopathological findings showed arterial thrombosis; therefore it was concluded that the second time shock was associated with purpura fulminans. Following this, his general status improved. He was transferred to another hospital for rehabilitation. The blood culture isolates were identified as Gemella bergeri and Eikenella corrodens. Gemella bergeri was identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry and confirmed by 16S rRNA gene sequencing later. The primary focus of the infection was thought to be in the right maxillary sinus, because the resolution of the fluid retention was confirmed by repeat computed tomography. CONCLUSIONS: Gemella bergeri can be the causative pathogen of septic shock. If this pathogen cannot be identified manually or through commercial phenotypic methods, 16S rRNA gene sequencing should be considered.

リンク情報
DOI
https://doi.org/10.1186/s12879-018-3437-6
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/30340466
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6194612
ID情報
  • DOI : 10.1186/s12879-018-3437-6
  • PubMed ID : 30340466
  • PubMed Central 記事ID : PMC6194612

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