著者

Kenichiro Yaita Ichiro Sameshima Hideaki Takeyama Shinpei Matsuyama Chie Nagahara Ryo Hashiguchi Yukiko Moronaga Nami Tottori Masanari Komatsu Yusuke Oshiro Yukihiro Yamaguchi

出版者

一般社団法人 日本内科学会

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.52, no.12, pp.1407-1412, 2013 (Released:2013-06-15)

参考文献数

25

被引用文献数

4 8

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A 77-year-old man had undergone left-lobe liver resection and a choledochojejunostomy six years previously, and thereafter he suffered from a postoperative relapse of cholangitis. He was admitted to our hospital due to liver abscesses and bacteremia caused by multidrug-resistant Pseudomonas aeruginosa. Empirical treatment with piperacillin/tazobactam was started, and the patient initially recovered. However, he developed a second case of sepsis caused by piperacillin/tazobactam-resistant P. aeruginosa bacteremia originating from a new liver abscess. We changed the piperacillin/tazobactam to colistin and flomoxef and continued the two antibiotics for one month. During the antibiotic therapy, the patient successfully underwent bile duct stent placement.

著者

Kenichiro Yaita Hideki Ohshima Makiko Hayashi Masayuki Nakamura Shin-ichiro Ueda Yoshiro Sakai Kenji Masunaga Koichi Ohshima Hiroshi Watanabe

出版者

日本プライマリ・ケア連合学会

雑誌

Journal of General and Family Medicine (ISSN:21896577)

巻号頁・発行日

vol.17, no.2, pp.176-178, 2016-06-18 (Released:2016-06-18)

参考文献数

7

著者

Kenichiro Yaita Takumitsu Suzuki Yukihiro Yoshimura Natsuo Tachikawa

出版者

一般社団法人 日本内科学会

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.52, no.12, pp.1439-1439, 2013 (Released:2013-06-15)

参考文献数

1

被引用文献数

1 4

著者

Kenichiro Yaita Yohei Sakamoto Kazuhiko Nakaharai Yukihiro Yoshimura Natsuo Tachikawa

出版者

日本プライマリ・ケア連合学会

雑誌

General Medicine (ISSN:13460072)

巻号頁・発行日

vol.15, no.1, pp.68-71, 2014-06-20 (Released:2014-06-27)

参考文献数

12

被引用文献数

1 2

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A 58-year-old female was admitted due to severe sepsis and multi-organ failure with a fulminant purpuric rash. Meropenem, vancomycin and levofloxacin were administered, although no focus of infection was detected. However, computed tomography revealed a profoundly hypoplastic spleen, and a blood smear detected Howell-Jolly bodies. Blood cultures grew Streptococcus pneumoniae (serotype 22F) three hours after admission. The patient was finally diagnosed as overwhelming pneumococcal sepsis with hyposplenism precipitated by splenic hypoplasia. Clinicians should pay attention to the splenic size and Howell-Jolly bodies in cases of sepsis of unknown origin.

著者

Kenichiro Yaita Yoshiro Sakai Kenji Masunaga Hiroshi Watanabe

出版者

一般社団法人 日本内科学会

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.55, no.6, pp.605-608, 2016 (Released:2016-03-15)

参考文献数

18

被引用文献数

2 7

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Objective To clarify the current situation concerning drug fever (DF) in Japan, we retrospectively analyzed patients undergoing infectious disease consultation at our institution. Methods Between April 2014 and May 2015, we extracted the records of DF patients from among 388 patients who had obtained infectious disease consultations in Kurume University Hospital. We reviewed their medical charts and summarized the characteristics of DF. Results This study included the records of 16 patients. Clinical signs (relative bradycardia, the duration of the drug administration before becoming febrile, and the interval between the discontinuation of a drug and the alleviation of a fever), and laboratory tests (varied white blood cell count, low level of C-reactive protein, and a mild elevation of transaminases) were compatible with those from previous reports. Among the drug-confirmed cases, five involved the use of glycopeptides (vancomycin: 3, teicoplanin: 2), which were considered to be uncommon causes, and the another five cases involved the use of β-lactams. In addition, the procalcitonin levels were either negative or low (≤0.25 ng/mL) in 10 of the 11 procalcitonin-measured cases. Conclusion Our findings demonstrated that glycopeptides, similar to β-lactams, may be the origin of DF. Furthermore, procalcitonin may be helpful in the diagnosis of DF, but only in combination with other detailed examinations.

著者

Kenichiro Yaita Yoshiro Sakai Jun Iwahashi Kenji Masunaga Nobuyuki Hamada Hiroshi Watanabe

出版者

一般社団法人 日本内科学会

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.55, no.7, pp.739-743, 2016 (Released:2016-04-01)

参考文献数

20

被引用文献数

1 5

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Objective To clarify the characteristics of post-travel consultation services in Japan, particularly in the provinces, we analyzed our post-travel patients in the travel clinic of Kurume University Hospital located in Kurume City (a regional hub City in southwestern Japan). Methods Sixty post-travel patients visited our clinic between April 2008 and October 2014 and participated in this study: 55 were Japanese and five were foreign. We summarized and compared the characteristics of the patients after dividing the Japanese participants into long-term travelers (>14 days) and short-term travelers (≤14 days). The foreign travelers were described in a separate analysis. Results Of the 55 Japanese travelers, the mean age (± standard deviation) was 37.3 ± 16.3 years, and 36 patients (65%) were men. Southeast Asia was the major destination (30/55, 55%), and business was stated as the major reason for travel (16/55, 29%). Post-exposure rabies prophylaxis (16/55, 29%) was the most common purpose for the consultations. There were 34 participants (62%) who were classified as short-term travelers. Fewer of the short-term travelers stated receiving pre-travel consultations compared with long-term travelers (11% vs. 79%, p=0.0002). The five foreign travelers included one dengue fever patient and two malaria patients. Conclusion Most post-travel Japanese patients visited our clinic were short-term travelers who had not received any pre-travel consultation. One of the most common complaints, post-exposure rabies prophylaxis, could have been avoided to some extent by appropriate pre-travel consultations. The results of this study suggest that pre-travel consultations should therefore be encouraged for both long- and short-term travelers.

著者

Kenichiro Yaita Masanari Komatsu Yusuke Oshiro Yukihiro Yamaguchi

出版者

一般社団法人 日本内科学会

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.51, no.18, pp.2645-2648, 2012 (Released:2012-09-15)

参考文献数

25

被引用文献数

3 7 1

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17-year-old man had been involved in a traffic accident. He underwent a bilateral craniotomy with artificial dura mater to remove bilateral acute subdural hematomas. Seven months later, a right cranioplasty was performed using frozen auto-bone, and he developed extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae meningitis and an epidural abscess. Since his general status was poor, we could not remove the foreign body (artificial dura mater). He was successfully treated with meropenem and chronic suppression with oral trimethoprim-sulfamethoxazole. By describing this case and the results of a review of the pertinent literature, we discuss the importance of ESBL-producing Klebsiella pneumoniae meningitis in posttraumatic/postoperative patients.

著者

HARUNA MIDORI KUMAMOTO KENICHIRO YAITA

出版者

Kurume University School of Medicine

雑誌

The Kurume Medical Journal (ISSN:00235679)

巻号頁・発行日

vol.66, no.4, pp.247-251, 2019-12-31 (Released:2021-12-15)

参考文献数

21

被引用文献数

1

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Summary: Nosocomial infective endocarditis is a relatively rare, but critical disease. A Japanese man in his 80s with psoriatic arthritis that was being treated with prednisolone was admitted for dyspnea. The first diagnosis was healthcare-associated pneumonia, and piperacillin/tazobactam was started. The patient’s blood culture was negative at the time of admission. During the treatment, acute kidney injury occurred due to the use of antibiotics. Hemodialysis was performed via a central venous catheter in the internal jugular vein. After treatment of pneumonia, the patient experienced a sudden onset of fever accompanied by a loss of consciousness. Blood cultures from the peripheral vein and the central venous catheter were positive for methicillin-susceptible Staphylococcus aureus. A transthoracic echocardiography revealed stringy strands of vegetation attached to the native mitral valve. Magnetic resonance imagings also showed a shower of emboli to the brain. Ceftriaxone and vancomycin were administered; however, the patient died following a massive cerebral infarction. Instances of in-hospital mortality from nosocomial endocarditis are higher than the rates of community-acquired endocarditis. Clinicians should pay close attention to risk factors for nosocomial infective endocarditis. These risk factors include long-term indwelling vascular devices, psoriatic arthritis and corticosteroid therapy.

著者

Kenichiro Yaita Kazuhiko Nakaharai Yukihiro Yoshimura Motoharu Hirano

出版者

一般社団法人 日本内科学会

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.53, no.14, pp.1591-1592, 2014 (Released:2014-07-15)

参考文献数

2

被引用文献数

4

著者

Kenichiro Yaita Takumitsu Suzuki Yukihiro Yoshimura Natsuo Tachikawa

出版者

一般社団法人 日本内科学会

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.51, no.22, pp.3231-3232, 2012 (Released:2012-11-15)

参考文献数

2

被引用文献数

2 2 2