著者

Haruhi Yamada Yukiko Katsumori Miki Kawano Shumpei Mori Ryo Takeshige Jun Mukai Hiroshi Imada Hiroyuki Shimoura Hachidai Takahashi Tadasu Horai Yutaka Okita Ken-ichi Hirata

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.57, no.12, pp.1763-1767, 2018-06-15 (Released:2018-06-15)

参考文献数

12

被引用文献数

5

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A 73-year-old man, with congestive heart failure due to combined valvar disease, underwent curative surgery. Although the surgery was successful, his clinical course was eventful because of pulmonary complications, and he began to deteriorate mentally. Quetiapine was prescribed, which appeared to effectively settle his mental status. Following the administration of quetiapine, however, he developed acute kidney injury (AKI) that required continuous hemodiafiltration. Subsequent to discontinuation of quetiapine, his renal function gradually improved. Atypical antipsychotic drugs, including quetiapine, are frequently used to treat delirium in elderly patients in the intensive-care setting. This case highlights a potential risk of quetiapine-related AKI.

著者

Yutaka Shimada Makoto Fujimoto Tatsuya Nogami Hidetoshi Watari Hideyuki Kitahara Hiroki Misawa Yoshiyuki Kimbara Kei-ichiro Kita

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.57, no.12, pp.1733-1740, 2018-06-15 (Released:2018-06-15)

参考文献数

26

被引用文献数

11

---

A 67-year-old woman experiencing coughing visited a clinic and was prescribed drugs, including shosaikoto extract, for 4 days. She subsequently suffered from liver injury, but her condition improved after the discontinuation of all medications. Approximately 1 year later, she experienced fatigue, consulted another clinic, and received saikokeishikankyoto extract for 21 days. She subsequently suffered liver injury again. Both shosaikoto and saikokeishikankyoto contain Scutellariae Radix. This case is thought to be one of recurrent drug-induced liver injury caused by the incidental readministration of a Kampo formula containing Scutellariae Radix. An awareness of adverse drug events caused by Kampo formulas, especially those containing Scutellariae Radix, is essential.

著者

Masaki Okamoto Masaki Tominaga Shigeki Shimizu Chiyo Yano Ken Masuda Masayuki Nakamura Yoshiaki Zaizen Takashi Nouno Satoshi Sakamoto Mitsuru Yokoyama Tomotaka Kawayama Tomoaki Hoshino

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.56, no.24, pp.3323-3326, 2017-12-15 (Released:2017-12-15)

参考文献数

19

被引用文献数

11

---

A 40-year-old female dental technician visited our hospital for the investigation of a chest X-ray abnormality. Chest computed tomography demonstrated centrilobular nodules and lung volume reduction, and her serum KL-6 level was elevated. A histological analysis of the specimens obtained on a surgical lung biopsy showed peribronchiolar fibrosis with pigmented macrophages and cholesterol clefts. An energy-dispersive X-ray analysis showed that these lung tissues contained some metals, including indium. The serum indium level was also elevated. We diagnosed this patient with pneumoconiosis caused by exposure to sandblasting certain dental metals. This is the first reported case of pneumoconiosis in a dental technician associated with exposure to indium.

著者

Masayuki Amano Taro Shimizu

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.57, no.18, pp.2607-2612, 2018-09-15 (Released:2018-09-15)

参考文献数

56

被引用文献数

67

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Mondor's disease (MD) is a rare disease that manifests with a palpable cord-like induration on the body surface. In general, MD is a self-limited, benign thrombophlebitis that resolves in four to eight weeks without any specific treatment. Cases of MD can be roughly categorized into three different groups based on the site of the lesion as follows: original MD of the anterolateral thoracoabdominal wall, penile MD with dorsum and dorsolateral aspects of the penis, and axillary web syndrome with mid-upper arm after axillary surgery. The diagnosis of MD is rather straightforward and based on a physical examinations. However, some case occur "secondary" with another underlying disease, including malignancy, a hypercoagulative state, and vasculitis. Therefore, it is critical to identify MD precisely, evaluate any possible underlying disease, and avoid any unnecessary invasive tests or treatment. In this paper, we comprehensively review the clinical characteristics of MD.

著者

Yuko Iwashita Masaki Ohya Satoko Kunimoto Yu Iwashita Toru Mima Shigeo Negi Takashi Shigematsu

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0108-17, (Released:2018-05-18)

参考文献数

25

被引用文献数

11

---

Objective This report presents a part of a survey pertaining to drug burden in maintenance hemodialysis patients in Japan. Methods A patient-reported questionnaire-based survey was conducted from September to November 2016 in six regions in Japan. Patients or Materials A total of 700 patients (50-79 years old) on maintenance hemodialysis for >3 years and members of the Japan Association of Kidney Disease Patients (JAKDP) were provided with the questionnaire. They were randomly selected using stratified sampling according to patient distribution observed from the Japanese Society for Dialysis Therapy Renal Data Registry (JSDT JRDR). Results A total of 524 (74.9%) patient questionnaires were evaluated (mean [standard deviation; SD] age, 66.6 [7.2] years; males, 63.4%; dialysis vintage, 16.9 [9.1] years). Patients' age, gender, and regional distribution were similar to the JSDT JRDR. They were taking an average (SD) of 16.4 (8.34) and 16.3 (8.55) oral medications/day on dialysis and nondialysis days, respectively. A majority of the patients were taking ≥10 oral medications/day on dialysis (75.1%) and nondialysis (74.4%) days, with phosphate binders being the most taken (7.0 tablets/day). A similar proportion (74.4%, 72.9%, respectively) was taking ≥6 different types of oral medications/day. Most patients were taking oral medications 3 (31%, 33%), 4 (24%, 22%), and ≥5 times (31%, 30%) a day, respectively. The drug burden was similar on dialysis and nondialysis days and did not vary with dialysis vintage. Conclusion The number, type, and frequency of oral medications in maintenance hemodialysis patients are high in Japan. The proportion of phosphate binders was highest among the prescription medications.

著者

Daijun Kirigaya Takeo Nakayama Tatsuro Ishizaki Shunya Ikeda Toshihiko Satoh

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.50, no.22, pp.2793-2800, 2011 (Released:2011-11-15)

参考文献数

31

被引用文献数

13 33

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Objective The aim of this study was to evaluate the adherence of guidelines for the management and treatment of glucocorticoid-induced osteoporosis, and to investigate whether it is associated with factors such as age, gender, glucocorticoid dose, physician specialty, and size of facility. Methods This was a cross-sectional study utilizing administrative data from a database of health insurance claims (2004-2007); 2,368 patients who received glucocorticoid treatment for≥90 days were extracted. The guideline adherence was determined by evaluations based on glucocorticoid prescription dose, prescription of anti-osteoporosis drugs, and whether or not bone mineral density was measured. Results Overall proportion of guideline adherence was 23.3%. In cases in which the equivalent dose of prednisolone was<5 mg/d and≥5 mg/d, the adherence was 8.3% and 30.5% respectively. Factors correlating with low adherence included young age, male gender, and lower glucocorticoid doses. Surgery and otolaryngology specialties had lower adherence than internal medicine. Smaller clinical facilities had lower adherence than larger facilities. Conclusion The adherence of guidelines for the management and treatment of glucocorticoid-induced osteoporosis is still low, and improvements in treatment quality can be expected through education of patient groups and medical care providers with large deviations from the guidelines.

著者

Masahiro Oomura Yuto Uchida Keita Sakurai Takanari Toyoda Kenji Okita Noriyuki Matsukawa

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0604-17, (Released:2018-04-27)

参考文献数

19

被引用文献数

6

---

We herein report a patient with Miller Fisher syndrome mimicking Tolosa-Hunt syndrome. A 47-year-old man presented with right orbital pain and diplopia. On a neurological examination, he had right oculomotor nerve palsy and diminished deep tendon reflexes. Brain magnetic resonance imaging failed to show any parenchymal lesions; however, the bilateral oculomotor nerves were gadolinium-enhanced. The presence of a triad of orbital pain, ipsilateral oculomotor nerve palsy, and a rapid response to steroid therapy met the diagnostic criteria for Tolosa-Hunt syndrome. After discharge, antibodies against GQ1b and GT1a were reported to be positive only with phosphatidic acid. The present case was ultimately diagnosed as an incomplete phenotype of Miller Fisher syndrome.

著者

Hirokazu Tokuyasu Takehito Fukushima Hirofumi Nakazaki Eiji Shimizu

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.51, no.9, pp.1133-1138, 2012 (Released:2012-04-29)

参考文献数

22

被引用文献数

3 17

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An 86-year-old woman who underwent placement of a prosthetic aortic valve for regurgitation 5 years previously was admitted because of spiking fever. The blood culture results were positive for gram-negative rods, which were identified as Achromobacter xylosoxidans. Approximately 4 months after being sent to the hospital, transthoracic echocardiography revealed vegetation at the prosthetic aortic valve. Ultimately, a diagnosis of A. xylosoxidans endocarditis of the prosthetic aortic valve was made. We report an extremely rare case of bacteremia associated by prosthetic valve endocarditis with A. xylosoxidans. In addition, we review 10 previously reported cases of endocarditis caused by A. xylosoxidans.

著者

Norihiko Shinozaki

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.51, no.12, pp.1527-1530, 2012 (Released:2012-06-15)

参考文献数

12

被引用文献数

2 2

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A 78-year-old man had right foot ulceration. The skin perfusion pressure (SPP) at the dorsum was 12 mmHg. Angiography revealed right iliac artery occlusion and diffuse stenosis of right superficial femoral artery. After stenting of the iliac arteries, the SPP was still 23 mmHg. Hence, we also inserted stents in the right superficial femoral artery. The anterior tibial artery remained stenosed, and the posterior tibial and fibular arteries were occluded. However, as the SPP had increased to 46 mmHg the treatment was discontinued. The ulcers improved. Measurement of SPP during a procedure may be useful in determining the treatment endpoint.

著者

Ryohei Ono Koji Uehara Izumi Kitagawa

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0219-17, (Released:2018-03-09)

参考文献数

32

被引用文献数

19

---

Emphysematous osteomyelitis is a rare but potentially fatal infection. It is caused by gas-forming organismsand is characterized by the presence of intraosseous gas. A 75-year-old woman with untreated diabetes mellitus presented with difficulty in moving and anorexia. Laboratory studies revealed inflammation, a urinary infection, and diabetic ketoacidosis. Klebsiella pneumoniae was detected in both urine and blood cultures. Computed tomography and magnetic resonance imaging revealed emphysematous lesions in the paravertebral soft tissue, spinal canal, and iliopsoas muscle, with intraosseous gas at L1 and L2. These findings led to a diagnosis of emphysematous osteomyelitis. We herein review 35 reported cases of emphysematous osteomyelitis including our case.

著者

Hiroyasu Kaya Jun Ozaki Hirokazu Okumura

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0269-17, (Released:2018-03-09)

参考文献数

22

被引用文献数

4

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Objective This study retrospectively evaluated fungal dissemination due to hospital reconstruction and explored effective methods of predicting an outbreak. Methods Patients suspected of having invasive aspergillosis were tested for Aspergillus galactomannan antigen before and after reconstruction, and the mean values of three months of testing for positive patients were determined. The characteristics of patients with aspergillosis during this period were also assessed. Results Forty-five patients were positive for Aspergillus antigen (>0.5 cut-off index) from January 2013 to December 2014. Mean Aspergillus antigen values significantly increased following reconstruction (p<0.05). Three patients developed pneumonia due to Aspergillus and were diagnosed with "probable" invasive aspergillosis according to the EORTC/MSG criteria. We also discovered that the anteroom to contain dust was not prefabricated and a negative pressure system to remove dust was not used. After construction of the unit, no new cases of aspergillosis were diagnosed. Conclusion Many Aspergillus spores may be transiently floating during hospital reconstruction. Therefore, monthly surveillance with frequent serum galactomannan antigen testing to predict outbreaks is necessary. Surveillance of all patients in the hematology ward is especially important. Reconsideration of prophylactic antifungals may also be necessary during hospital reconstruction.

著者

Tsugumi Takayama Takuya Ozawa Akiko Sanada Tohru Watanabe Masahiro Ito Satoru Hirono Yoshifusa Aizawa Tohru Minamino

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.57, no.6, pp.823-827, 2018-03-15 (Released:2018-03-15)

参考文献数

14

被引用文献数

2

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A 33-year-old man with severe aortic regurgitation underwent initial aortic valve replacement (AVR). During the 2 years after AVR, 3 reoperations for prosthetic valve detachment were required. During hospitalization, he had no typical clinical findings, with the exception of a persistent inflammatory reaction; a pseudo-aneurysm around the Bentall graft developed 27 days after the 4th operation. This unique clinical course suggested the possibility of Behçet's disease. In the 8 years of follow-up after the administration of prednisolone, the pseudo-aneurysm did not become enlarged and the detachment of the prosthetic valve was not observed. We herein present a case of cardiovascular Behçet's disease, with a review of the literature.

著者

Ryosuke Imai Takakazu Higuchi Masaya Morimoto Ryosuke Koyamada Sadamu Okada

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.57, no.6, pp.899-901, 2018-03-15 (Released:2018-03-15)

参考文献数

11

被引用文献数

18

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A 52-year-old man who had been taking omeprazole, a proton pump inhibitor (PPI), for 25 years developed iron deficiency anemia. An evaluation of the entire gastrointestinal tract did not reveal any possible causes of gastrointestinal blood loss. The cause of the iron deficiency was considered to be a reduction in gastrointestinal iron absorption in association with the reduced secretion of gastric acid due to PPI use. This case demonstrates that long-term PPI use for as long as 25 years may cause iron deficiency anemia and should be considered in the differential diagnosis of iron deficiency anemia in long-term PPI users.

著者

Tatsuya Ueno Ryoya Kimura Tomoya Kon Rie Haga Haruo Nishijima Jin-ichi Nunomura Masahiko Tomiyama

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0313-17, (Released:2018-02-28)

参考文献数

21

被引用文献数

3

---

Miller Fisher syndrome (MFS) can be difficult to diagnose, particularly in mild cases where some of the standard triad of symptoms (external ophthalmoplegia, ataxia, and loss of deep tendon reflex) are absent. We herein report a case of the incomplete form of MFS diagnosed in a 54-year-old Japanese man who presented only with ataxia symptoms and was positive for the anti-GQ1b antibody. However, the patient also suffered from dysgeusia, a significant impairment of taste perception. We propose that dysgeusia in acute-onset ataxia cases may constitute an important clinical feature to aid in the diagnosis of the incomplete form of MFS.

著者

Ryuko Furutate Takeo Ishii Takashi Motegi Kumiko Hattori Yuji Kusunoki Akihiko Gemma Kozui Kida

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.55, no.3, pp.223-229, 2016 (Released:2016-02-01)

参考文献数

45

被引用文献数

13 46

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Objective Although chronic obstructive pulmonary disease (COPD) is characterized by systemic inflammation, the association between the neutrophil to lymphocyte ratio (NLR; an indicator of inflammation) and the clinical status of COPD has not been well studied. We hypothesized that the NLR is associated with disease severity and exacerbation in COPD patients. Methods We performed blood testing, pulmonary function testing, chest computed tomography, a body composition analysis, and a 6-minute walk test and applied the modified Medical Research Council (MMRC) dyspnea scale for 141 stable COPD patients. In addition, we calculated the body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index to evaluate the disease severity. Finally, we examined the association between the NLR and clinical parameters in stable COPD patients, and we further investigated changes in the NLR between exacerbation and the stable state. Results The NLR was positively correlated with the BODE index, extent of emphysema, and MMRC score (p<0.001 for all), while inversely correlated with airflow obstruction (p<0.001), body mass index (p<0.001), fat-free mass index (p=0.001), and the 6-minute walk distance (p<0.001). We obtained the NLR during exacerbation from 49 patients. The NLR was significantly higher at exacerbation compared to the stable state (p<0.001). Conclusion The NLR was associated with disease severity and exacerbation in COPD patients. Therefore, the usefulness of the NLR in COPD patients should be elucidated in clinical settings in future investigations.

著者

Takashi Wada Tsutomu Fukumoto Kyoko Ito Yasutaka Hasegawa Takanobu Osaki Hideyuki Ban

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.48, no.9, pp.647-655, 2009 (Released:2009-05-01)

参考文献数

20

被引用文献数

7 8

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Objective Metabolic syndrome is associated with a high risk of cardiovascular morbidity and mortality. The predominant cause of metabolic syndrome is an unhealthy lifestyle. Healthy habits are represented by Breslow's 7 healthy practices, Morimoto's 8 items and Ikeda's 6 healthy habits. This study was done to determine which set of healthy habits was most likely to result in a reduced risk of developing the metabolic syndrome. Methods From April 1, 2000 through March 31, 2007, 6,765 males and 2,789 females underwent a medical check-up at Jikei University Hospital in Japan. They completed a simple, self-administered lifestyle questionnaire based on the 3 classifications of healthy habits. The responses were divided into 3 groups (poor, moderate and favorable) according to each of the healthy habit criteria. The incidence of metabolic syndrome was defined in participants who were newly diagnosed during the follow-up using Japanese-specific diagnostic criteria. The Kaplan-Meier cumulative 7-year incidence was calculated. Kaplan-Meier curves were compared using the long-rank test adjusted for age. Results In females, Breslow's, Morimoto's and Ikeda's healthy habits showed significant differences in the incidence between poor and moderate groups, and between poor and favorable groups. In males, a significant difference was observed among the poor, moderate and favorable groups for Ikeda's healthy habits. However, no significant difference was observed for Breslow's healthy practices. Morimoto's items only showed a significant difference between the poor and moderate groups. Conclusion Among the 3 models tested, Ikeda's healthy habits were the most useful for decreasing the risk of metabolic syndrome in Japanese.

著者

Wada Takashi Fukumoto Tsutomu Ito Kyoko Hasegawa Yasutaka Osaki Takanobu Ban Hideyuki

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.48, no.9, pp.647-655, 2009

被引用文献数

1 8

---

<b>Objective</b> Metabolic syndrome is associated with a high risk of cardiovascular morbidity and mortality. The predominant cause of metabolic syndrome is an unhealthy lifestyle. Healthy habits are represented by Breslow's 7 healthy practices, Morimoto's 8 items and Ikeda's 6 healthy habits. This study was done to determine which set of healthy habits was most likely to result in a reduced risk of developing the metabolic syndrome.<br> <b>Methods</b> From April 1, 2000 through March 31, 2007, 6,765 males and 2,789 females underwent a medical check-up at Jikei University Hospital in Japan. They completed a simple, self-administered lifestyle questionnaire based on the 3 classifications of healthy habits. The responses were divided into 3 groups (poor, moderate and favorable) according to each of the healthy habit criteria. The incidence of metabolic syndrome was defined in participants who were newly diagnosed during the follow-up using Japanese-specific diagnostic criteria. The Kaplan-Meier cumulative 7-year incidence was calculated. Kaplan-Meier curves were compared using the long-rank test adjusted for age.<br> <b>Results</b> In females, Breslow's, Morimoto's and Ikeda's healthy habits showed significant differences in the incidence between poor and moderate groups, and between poor and favorable groups. In males, a significant difference was observed among the poor, moderate and favorable groups for Ikeda's healthy habits. However, no significant difference was observed for Breslow's healthy practices. Morimoto's items only showed a significant difference between the poor and moderate groups.<br> <b>Conclusion</b> Among the 3 models tested, Ikeda's healthy habits were the most useful for decreasing the risk of metabolic syndrome in Japanese.<br>

著者

Tetsuo Yamaguchi Masahiro Terashima Chisato Takamura Hironobu Sakurai Kiyotoshi Ooishi Tomoya Yoshizaki Junji Yamaguchi Sadahiro Hijikata Takamasa Iwai Yuichiro Sagawa Keita Watanabe Ryoichi Miyazaki Ryo Masuda Naoyuki Miwa Masahiro Sekigawa Nobuhiro Hara Yasutoshi Nagata Takamichi Miyamoto Toru Obayashi Toshihiro Nozato

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.9605-17, (Released:2017-12-21)

参考文献数

11

被引用文献数

3

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A 55-year-old man presented with dyspnea, edema, and appetite loss. He had undergone coronary artery bypass grafting 8 years previously. He had jugular venous distention and Kussmaul's sign. Contrast-enhanced cardiac magnetic resonance imaging (CMRI) demonstrated an intrapericardial mass compressing the right ventricular (RV) cavity. T1- and T2-weighted black-blood images showed a mass with heterogeneous high signal intensity and a thick and dark rim. The mass was considered to be a chronic hematoma. After pericardiotomy with surgical removal of the hematoma, CMRI showed the marked improvement of the RV function. Late intrapericardial hematoma is rare and CMRI is useful for making a differential diagnosis.

著者

Yoshie Ojima Kinya Sawada Hiroshi Fujii Tsuyoshi Shirai Ayako Saito Saeko Kagaya Satoshi Aoki Yoichi Takeuchi Tomonori Ishii Tasuku Nagasawa

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.9848-17, (Released:2017-12-27)

参考文献数

47

被引用文献数

7

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A previously healthy 58-year-old man was admitted for muscle pain and weakness (manual muscle testing [MMT] of 4/4 for upper and lower limbs). We detected elevated levels of inflammatory makers and PR3-anti-neutrophil cytoplasmic antibody (ANCA). Subsequently, the muscle weakness rapidly progressed to an MMT of 2 for all limbs. Magnetic resonance imaging indicated muscle edema, and the CK level increased to 29,998 U/L. mPSL and cyclophosphamide pulse therapy improved the patient symptoms. MMT recovered to 4 for all limbs. A muscle biopsy showed degenerated muscle fibers surrounded by neutrophil-predominant infiltration. In addition, lamina elastic breakdown and fibrinoid necrosis of arterioles were observed. A final diagnosis of microscopic polyangiitis (MPA) limited to the muscles was made.

著者

Takeshi Numata Norihito Hida Kai Yazaki Naoki Arai Kyoko Ota Hidetoshi Yanai Takeo Endo

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.9399-17, (Released:2017-11-01)

参考文献数

23

被引用文献数

6

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A 39-year-old woman received a seasonal influenza vaccine in November 2015 and subsequently experienced malaise, low-grade fever, and chest discomfort. A chest X-ray performed 2 weeks after vaccination showed multiple nodular shadows in both lungs and ground-glass shadows in both lower lung fields. Her bronchoalveolar lavage fluid contained an unusually high number of lymphocytes, and a drug-induced lymphocyte stimulation test for seasonal influenza vaccine was positive. Transbronchial lung biopsy revealed the presence of granulomatous inflammation. Thereafter her abnormal chest shadow spontaneously improved. Based on these findings, the patient was diagnosed with drug-induced pneumonitis due to an influenza vaccine.