著者

Yasutaka Mochizuka Masato Kono Mineo Katsumata Ryutaro Hirama Masayuki Watanuki Yuiko Oshima Kenichiro Takeda Akari Tsutsumi Hideki Miwa Yoshihiro Miki Dai Hashimoto Noriyuki Enomoto Yutaro Nakamura Takafumi Suda Hidenori Nakamura

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.7533-21, (Released:2021-07-30)

参考文献数

18

被引用文献数

3

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A 67-year-old man was admitted to our hospital with cough and fatigue. He had had long-term exposure to silica due to cement processing. Chest computed tomography showed bilateral centrilobular nodules, and hilar and mediastinal lymphadenopathy with calcification, suggesting chronic silicosis. Within a few months, these nodules enlarged, and bilateral patchy consolidations appeared. A lung biopsy revealed sarcoid-like granulomas with birefringent particles under polarized light without malignancy or infection. He was diagnosed with silicosis-associated sarcoid-like granulomatous lung disease, rather than sarcoidosis, according to the clinicopathological findings. His pulmonary manifestations improved after the discontinuation of silica exposure and combination therapy of corticosteroid and azathioprine.

著者

Hidemi Ogawa Kenichiro Takeda Ryotaro Yoneoka Kohei Shikano Mitsuhiro Abe Hajime Kasai Takuji Suzuki

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.2590-23, (Released:2023-11-27)

参考文献数

21

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Pneumonia caused by Legionella longbeachae, transmitted through contaminated soil, is very rare in Japan. A 70-year-old man with severe respiratory failure was admitted to our hospital and underwent multidisciplinary procedures. Although a urinary antigen test was negative for Legionella, he was clinically diagnosed with legionellosis and administered levofloxacin. His condition subsequently improved. Thereafter, sputum culture detected L. longbeachae. Because the DNA of L. longbeachae was detected in the gardening soil, it is suspected source of infection. Therefore, it is important to suspect legionellosis based on clinical information, even if a urine antigen test is negative.