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論文 |
論文
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Matsumura, Masami ; Ito, Kiyoaki ; Kawamura, Rika ; Fujii, Hiroshi ; Inoue, Ryo ; Yamada, Kazunori ; Yamagishi, Masakazu ; Kawano, Mitsuhiro
概要:
A 53-year-old woman with systemic lupus erythematosus presented with a 3-day history of fever and coughing. Diagnosis of
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pneumococcal bronchitis was made based on symptoms and positivity of pneumococcal urinary antigen test. On day 3, severe low back pain acutely occurred. Pneumococcal vertebral osteomyelitis and psoas abscess was diagnosed 17 days later by yield of penicillin-susceptible S. pneumoniae strain in blood cultures and drainage fluid. Although pneumococcal urinary antigen test is a useful tool for the diagnosis of pneumococcal pneumonia, we should consider the possibility of pneumococcal infections other than pneumonia or overwhelming bacteremia in immunosuppressive patients when urinary antigen test is positive © 2011 The Japanese Society of Internal Medicine.
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| 2.
論文 |
論文
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Matsumura, Masami ; Kawamura, Rika ; Inoue, Ryo ; Kawano, Mitsuhiro ; Yamagishi, Masakazu
概要:
金沢大学医薬保健研究域医学系医学教育研究センター<br />Cryptococcal meningitis is a recognized complication of systemic lupus erythematosus (SLE)
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, with high mortality rates, particularly in those treated with immunosuppressive agents. We describe a patient diagnosed simultaneously with cryptococcal meningoencephalitis and SLE and reviewed four similar cases reported in the literature. In our case, profound low CD4 lymphocyte count and low complement levels were observed. The patient was treated with prednisolone, fluconazole, and 5-flucytosine and evinced good clinical improvement. This case suggests that intrinsic immunological abnormality related to SLE predisposed to opportunistic infections. © 2010 Japan College of Rheumatology.
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