著者

Kentaro Iwata Naomi Morishita Masami Nishiwaki Chisato Miyakoshi

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.3477-19, (Released:2020-07-14)

参考文献数

10

被引用文献数

2

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Objectives Treating latent tuberculosis infection (LTBI) is essential for eliminating the serious endemicity of tuberculosis. A shorter regimen is preferred to longer regimens because the former has better adherence with a better safety profile. However, lengthy treatment with isoniazid is still recommended in Japan. Based on the latest evidence, we switched from a conventional nine-month isoniazid regimen to a shorter four-month rifampin regimen for the treatment of LTBI. Methods To evaluate the safety and efficacy of the shorter regimen, we conducted Bayesian analyses using a stochastic mathematical model to calculate the posterior probabilities of several parameters. Patients Clinical data of 13 patients in the isoniazid group and 5 in the rifampin group were used for the Bayesian analyses. The outcomes measured were completion of the treatment, adverse effects, number of clinic visits, and medical costs. Results The medial posterior probability of the isoniazid group completing the treatment was 66% [95% credible interval (CrI) 43%-89%], whereas that of the rifampin group was 86% (95% CrI 60%-100%). The probability that the completion rate in the rifampin group was better than that in the isoniazid group was as high as 88% (95% CrI 0%-100%). Other parameters, such as the number of clinical visits and duration of treatment, were better with rifampin therapy than with isoniazid therapy, with comparable medical costs. Conclusion Four months of rifampin therapy might be preferred to isoniazid for treating LTBI in Japan.

著者

Kentaro Iwata Yoshie Takai Nozomi Kitada Naomi Morishita Hiroaki Kiyona

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0595-22, (Released:2022-10-26)

参考文献数

11

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Mycobacterium marinum is a ubiquitous organism inhabiting both fresh and salt water. It can cause human diseases such as skin and soft tissue infection. The organism is also known to cause a false positive reaction to interferon-γ release assay, the test to diagnose latent tuberculosis infection. Here, we present a case of submandibular nodule caused by M. marinum with positive T-SPOT.TB test, which was likely to be false positive.

著者

Miho Fujio Takafumi Watanabe Naomi Morishita Sachiyo Ohtani Kentaro Iwata

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.7755-21, (Released:2021-08-13)

参考文献数

15

被引用文献数

1

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Listeria monocytogenes can cause gastrointestinal infections in healthy children and adults, but they tend to be mild and self-limiting. It can, however, cause serious potentially lethal infections, such as meningitis and bacteremia, to those with underlying conditions. A woman in her 60s with liver cirrhosis developed abdominal pain and a fever, and she turned out to have a perianal abscess caused by L. monocytogenes. Perianal abscess is a rare complication of L. monocytogenes, but a recent epidemiological study revealed that the presence of cirrhosis might also be a risk factor for the development of invasive disease.