- 著者
- Yuwa Oka Akihiro Ueda Tomokazu Nakagawa Yujiro Kikuchi Daiki Inoue Satoshi Marumo Sadayuki Matsumoto
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- pp.8123-21, (Released:2021-08-06)
- 参考文献数
- 9
- 被引用文献数
- 5
We herein report a 49-year-old man with a fever, diagnosed with SARS-CoV-2 infection. After two weeks of hospitalization, he suddenly mentioned visual field impairment. Computed tomography and magnetic resonance imaging revealed white matter damage and vasogenic edema. Cerebrospinal fluid showed increased levels of IL-6. His symptoms and white matter lesion deteriorated. After treatment with intravenous methylprednisolone therapy and plasmapheresis, his symptoms and white matter lesion improved gradually. We suspect that our patient was affected by a secondary hyperinflammatory syndrome related to cytokines, alone or in combination with direct viral injury through endothelial cell damage. The IL-6 levels were elevated only in the cerebrospinal fluid, suggesting focal central nervous system inflammation.
- 著者
- Tasuku Yamamoto Keiji Oishi Junki Suizu Keita Murakawa Yukari Hisamoto Tetsuya Fujii Misa Harada Ayumi Chikumoto Yujiro Kikuchi Kazuki Hamada Sho Uehara Syuichiro Ohata Yoriyuki Murata Kenji Sakamoto Yoshikazu Yamaji Maki Asami-Noyama Nobutaka Edakuni Tomoyuki Kakugawa Tsunahiko Hirano Kazuto Matsunaga
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- pp.8805-21, (Released:2022-03-19)
- 参考文献数
- 22
Both 1,3-beta-D-glucan (BDG) and galactomannan (GM) are polysaccharide components of the fungal cell wall. Although elevated levels of serum BDG and Aspergillus GM suggest invasive fungal infection or Pneumocystis pneumonia and aspergillosis, respectively, it is also necessary to consider the possibility of false-positives. We herein report a 68-year-old man with marked elevation in serum BDG and GM levels accompanied by Mendelson's syndrome after rice aspiration. With the improvement of Mendelson's syndrome, his serum BDG and GM levels decreased. The false-positive serum BDG and GM findings may have been due to his aspiration of food containing them. It is important to take a detailed history of aspiration in addition to making a conventional differential diagnosis in patients with pneumonia with elevated serum BDG and GM levels.