感染症学雑誌
Online ISSN : 1884-569X
Print ISSN : 0387-5911
ISSN-L : 0387-5911
症例
permucoviscosity phenotype の Klebsiella pneumoniaeによる肝膿瘍・敗血症性肺塞栓症の重症例
中本 啓太郎小出 卓長友 禎子田村 仁樹檜垣 学高田 佐織和田 裕雄石井 晴之岡崎 充宏高橋 信一後藤 元
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2011 年 85 巻 4 号 p. 366-369

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A 70-year-old man with diabetes mellitus seen for fever, right chest pain, and right-lung field consolidation on chest X-ray was found in thoracoabdominal computed tomography (CT) to have variable-sized nodules in both lung fields and multiple low-density hepatic areas. On physical examination, his pulse was 145 beats per minute and blood pressure 92/68mmHg, indicating a preshock state. Laboratory tests showed elevated WBC of 15,200/μL, serum-C-reactive protein (CRP) of 34.4mg/dL, and a decreased platelet count of 16,000/μL. Suspecting liver abscesses complicated by aseptic pulmonary embolism, we immediately conducted percutaneous transhepatic abscess drainage (PTAD). Liver abscess blood culture and drainage fluidgrew the Klebsiella pneumoniae hypermucoviscosity phenotype, carrying the rmpA gene. Although the man had been in critical condition on admission, broad-spectrum antibiotics and PTAD treatment improved his clinical condition to where he could be discharged without problem.

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© 2011 社団法人 日本感染症学会
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