論文

査読有り 国際誌
2019年5月

Clostridioides difficile-related toxic megacolon after Cryptococcus neoformans cellulitis: A complex of two rare infections in an immunocompromised host.

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy
  • Yusuke Koizumi
  • ,
  • Asako Kachi
  • ,
  • Kenji Tsuboi
  • ,
  • Jun Muto
  • ,
  • Hiroki Watanabe
  • ,
  • Nobuhiro Asai
  • ,
  • Hironobu Nobata
  • ,
  • Arufumi Shiota
  • ,
  • Hideo Kato
  • ,
  • Daisuke Sakanashi
  • ,
  • Mao Hagihara
  • ,
  • Yuka Yamagishi
  • ,
  • Hiroyuki Suematsu
  • ,
  • Shogo Banno
  • ,
  • Hiroshige Mikamo

25
5
開始ページ
379
終了ページ
384
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.jiac.2018.12.003

A 76-year-old Japanese woman was admitted due to uncontrolled cellulitis of the right lower leg. She had deep vein thrombosis on the right limb. Moreover, she had a long history of rheumatoid arthritis treated with corticosteroids. Skin biopsy and lumbar puncture were performed to diagnose disseminated cryptococcosis. She was administered antifungal agents (liposomal amphotericin B and 5-fluorocytosine). On treatment day 14, debridement was performed, and cryptococcosis was controlled. However, she developed toxic megacolon due to Clostridioides difficile infection (CDI). On day 32, she was transferred to the intensive care unit due to severe acidosis and acute kidney injury secondary to CDI-related toxic megacolon. Vancomycin, metronidazole, and tigecycline were administered for treatment of CDI. After several weeks of intensive care, toxic megacolon was improved, but renal replacement therapy was discontinued according to the patient's will. On day 73, she died of renal failure. We experienced a complex of rare diseases, Cryptococcus neoformans cellulitis and Clostridioides difficile-related toxic megacolon. Both diseases were presumed to be the result of corticosteroid and methotrexate use. Hence, careful monitoring is required when treating immunocompromised hosts to reduce the risk of developing complications.

リンク情報
DOI
https://doi.org/10.1016/j.jiac.2018.12.003
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/30797689

エクスポート
BibTeX RIS