著者

澤木 賢司 佐々木 裕明 堀内 弘司 宮田 順之 藤代 夏純 小菅 葉子 北尾 泉 松本 裕子 吉村 幸浩 立川 夏夫

出版者

一般社団法人 日本感染症学会

雑誌

感染症学雑誌 (ISSN:03875911)

巻号頁・発行日

vol.93, no.5, pp.655-658, 2019-09-20 (Released:2020-04-03)

参考文献数

13

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Although biosafety in laboratories is very important, the risk of laboratory-acquired infection is usually undervalued. We report herein on two cases of laboratory-acquired infection caused by enterohemorrhagic Escherichia coli (EHEC) during student training in our hospital. We have to recognize laboratories are at risk of infection and reconsider the infection control rule.

著者

原 怜 佐南谷 瑞 立川 夏夫 吉村 幸浩 宮田 順之 佐々木 裕明 黒田 理佐 上國料 千夏 江口 智洋 新山 修平 垣花 泰之 一瀬 宏

出版者

公益社団法人 日本ビタミン学会

雑誌

ビタミン (ISSN:0006386X)

巻号頁・発行日

vol.96, no.1, pp.16-17, 2022 (Released:2023-01-31)

著者

堀内 弘司 佐々木 裕明 宮田 順之 吉村 幸浩 原田 壮平 立川 夏夫

出版者

一般社団法人 日本感染症学会

雑誌

感染症学雑誌 (ISSN:03875911)

巻号頁・発行日

vol.95, no.3, pp.324-327, 2021-05-20 (Released:2021-11-26)

参考文献数

7

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Klebsiella pneumoniae independently causing necrotizing fasciitis in patients with Klebsiella pneumoniae bacteremia is known and has mainly been reported from East Asia, especially Taiwan and Korea. The clinical course of necrotizing fasciitis developing in association with K. pneumoniae bacteremia has not yet been clearly described. We report a case of lower leg K. pneumoniae necrotizing fasciitis in a patient with following K. pneumoniae bacteremia, which was unrecognized on day 1 of admission. The necrotizing fasciitis, which necessitated surgical treatment, became clinically evident only after the bacteremia diagnosis. A 65- year-old Korean woman who presented with a history of fever and malaise developed septic shock of unknown origin. Although effective antimicrobial therapy was initiated soon after she was admitted to us, purpura and pain in the left lower leg appeared on day 6 of admission, and necrotizing fasciitis was suspected. The patient recovered after surgical treatment and was discharged on day 25 of hospitalization. The isolated K. pneumoniae showed a positive string test, and genetic analysis identified it as the K1-ST23 strain, which is known to be a hypervirulent K. pneumoniae (hvKp) strain. It has been suggested that hvKp bacteremia can cause necrotizing fasciitis even during effective antimicrobial therapy, and because of the need for immediate surgical treatment, clinicians should be very attentive to the appearance of a new skin or soft tissue lesion in patients with K. pneumoniae bacteremia. The index of suspicion should be even higher in patients from East Asia and for K. pneumoniae strains that are string test-positive.

著者

天野 雄一郎 宮田 順之 鈴木 琢光 吉村 幸浩 立川 夏夫

出版者

一般社団法人 日本感染症学会

雑誌

感染症学雑誌 (ISSN:03875911)

巻号頁・発行日

vol.92, no.5, pp.690-695, 2018-09-20 (Released:2019-12-01)

参考文献数

20

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We report herein on a 61-year-old Japanese man with severe falciparum malaria after visiting African countries. He presented with shock, impaired consciousness, acidosis, renal impairment, jaundice, pulmonary edema and hyperparasitemia (42.7%). We admitted him to our intensive-care unit. He was initially treated with intravenous quinine (4,500mg for 3 days), rectal artesunate (1,200mg for 5days) and aggressive supportive therapy. The sequential treatment was mefloquine on day 7 (1,925mg). The 99% parasite clearance time and ICU stay were 92 hours and 8days, respectively. He was discharged without complications on the 28th day. Severe malaria, especially cerebral malaria, is a highly mortal disease requiring urgent treatment. Intravenous artesunate is now recommended as the treatment of choice for severe malaria by the World Health Organization, but it is unavilable in Japan. We found that our combination treatment had excellent antimalarial activity with rapid efficacy, and was safe and well-tolerated.