著者

Yoshiro Hadano Hajime Yoshii Michio Hayashi Hiroshi Oono Reiko Tanaka

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.54, no.9, pp.1141-1143, 2015 (Released:2015-05-01)

参考文献数

6

被引用文献数

1

---

Cryptococcus arboriformis (C. arboriformis) is a novel Cryptococcus species belonging to the genus Trichosporonales. This novel species was identified definitively in 2007 using D1/D2 26S ribosomal DNA gene sequencing. In this article, we present a rare case of central line-associated bloodstream infection caused by C. arboriformis with successful treatment of this infection.

著者

Jumpei Taniguchi Kei Nakashima Hiroyuki Ito Yu Tanaka Ayumu Otsuki Akihiro Shiroshita Michinori Yoshimi Norihiko Kubota Masahiro Aoshima

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.4624-20, (Released:2020-06-15)

参考文献数

24

---

Sarcoidosis is a multisystem granulomatous disease of unknown etiology and is pathologically characterized by non-caseating granulomas in the organs involved. We herein report a case of sarcoidosis in a Japanese woman with acute respiratory failure, diagnosed using endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) on the ventilator after intubation. Only a few cases of previously undiagnosed sarcoidosis presenting acute respiratory failure have been reported. It is important to be aware that undiagnosed sarcoidosis may present with acute respiratory failure. Therefore, EBUS-TBNA under mechanical ventilation may be useful for the immediate diagnosis of patients.

著者

Kei Endo Keisuke Kakisaka Yuji Suzuki Takayuki Matsumoto Yasuhiro Takikawa

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.56, no.22, pp.3019-3022, 2017-11-15 (Released:2017-11-15)

参考文献数

10

被引用文献数

5

---

An 82-year-old Japanese man visited our hospital with abdominal fullness accompanied by lower abdominal pain. He presented with small bowel obstruction due to multiple diospyrobezoars. The bezoars were successfully removed without any surgical intervention by the administration of Coca-Cola Zero through a long intestinal tube and subsequent endoscopic manipulation. Such a combination may be the treatment of choice for small bowel obstruction due to bezoars.

著者

Shion Miyoshi Jin Takasaki Sohtaro Mine Masanori Kono Toru Igari Yuichiro Takeda Masayuki Hojo Haruhito Sugiyama

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.56, no.9, pp.1079-1083, 2017-05-01 (Released:2017-05-01)

参考文献数

16

被引用文献数

3

---

Anti-tumor necrosis factor α (anti-TNFα) agents increase the risk of tuberculosis (TB), but cases are rarely fatal. This report concerns a patient who was undergoing treatment with infliximab and presented with acute respiratory distress syndrome due to miliary TB without a miliary shadow. The findings of a pathological autopsy revealed innumerable granulomas in the organs, and the miliary nodules in the lung consisted of more unstructured granulomas. Anti-TNFα agents are unusual in the presentation of TB. It is important, particularly for patients receiving anti-TNFα agents, to constantly consider the possibility of TB and to prepare for appropriate management.

著者

Tomomi Kinoshita Shu-ichi Ikeda

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.54, no.15, pp.1955, 2015 (Released:2015-08-01)

参考文献数

6

被引用文献数

2 2

著者

Julia M.L. Brotherton Kristine K. Macartney Etsuko Miyagi Jim P. Buttery

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.54, no.19, pp.2531-2531, 2015 (Released:2015-10-01)

参考文献数

3

被引用文献数

1 1

著者

Reina Kawamura Eiichiro Nagata Masako Mukai Yoichi Ohnuki Tomohiko Matsuzaki Kana Ohiwa Tomoki Nakagawa Mitsutomo Kohno Ryota Masuda Masayuki Iwazaki Shunya Takizawa

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.3357-3359, 2017-12-15 (Released:2017-12-15)

参考文献数

9

被引用文献数

28

---

A 54-year-old woman with adenocarcinoma of the lung and lymph node metastasis experienced nystagmus and cerebellar ataxia 2 weeks after initiating nivolumab therapy. An evaluation for several autoimmune-related antibodies and paraneoplastic syndrome yielded negative results. We eventually diagnosed the patient with nivolumab-induced acute cerebellar ataxia, after excluding other potential conditions. Her ataxic gait and nystagmus resolved shortly after intravenous steroid pulse therapy followed by the administration of decreasing doses of oral steroids. Nivolumab, an immune checkpoint inhibitor, is known to induce various neurological adverse events. However, this is the first report of acute cerebellar ataxia associated with nivolumab treatment.

著者

Yoshiki Nakae Mizuki Hyuga Wataru Kishimoto Akiko Fukunaga Sumie Tabata Yoshitomo Maesako Nobuyoshi Arima Yuta Terada Kenichi Komatsu Osamu Higuchi Shunya Nakane

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

pp.9096-17, (Released:2017-10-11)

参考文献数

25

被引用文献数

5

---

Autoimmune autonomic ganglionopathy is an autonomic disorder that occurs as a symptom of paraneoplastic neurological syndrome. To date, there have been no reports on multiple myeloma with autoimmune autonomic ganglionopathy. A 37-year-old Japanese woman suffered from orthostatic hypotension was diagnosed with multiple myeloma (IgG kappa type), and a serological examination revealed the presence of anti-ganglionic nicotinic acetylcholine receptor (anti-gAChR) antibodies. She was treated for multiple myeloma, as a result, the autonomic disturbance improved and her anti-gAChR antibody titer decreased to undetectable levels, despite the fact that she only achieved a partial remission of multiple myeloma. Treatment for multiple myeloma may improve autoimmune autonomic ganglionopathy.

著者

Naoya Itoh Harutaka Katano Shu-ichi Nakayama Hanako Kurai

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.56, no.13, pp.1753-1753, 2017-07-01 (Released:2017-07-01)

参考文献数

2

被引用文献数

2

著者

Kohta Katayama Ryo Kumagai Momoko Isono Kazuya Fujihara Hiroaki Yagyu Gen Ohara Katsunori Kagohashi Hiroaki Satoh

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.13, pp.1779-1782, 2016-07-01 (Released:2016-07-01)

参考文献数

14

被引用文献数

1 2

---

An 85-year-old woman with diabetes mellitus was admitted to our hospital due to progressive dyspnea. Two months previously, pioglitazone had been newly prescribed for diabetes management. Bilateral ground-glass opacities and progressive respiratory deterioration suggested respiratory failure due to a drug-induced lung injury. With discontinuation of pioglitazone and the administration of a corticosteroid, an improvement in her respiratory condition was achieved, although sequelae remained in some areas of the lungs. Results of drug-induced lymphocyte stimulation tests were positive for pioglitazone. Resumption of other drugs did not reinduce the lung injury. Therefore, a diagnosis of pioglitazone-induced lung injury was made. Although pioglitazone-induced lung injury is very rare, clinicians should keep it in mind when pioglitazone is used.

著者

Hideharu Hagiya Tomohiro Terasaka Kosuke Kimura Asuka Satou Kikuko Asano Koichi Waseda Yoshihisa Hanayama Fumio Otsuka

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.18, pp.2159-2163, 2014 (Released:2014-09-15)

参考文献数

37

被引用文献数

1 5

---

We herein report a case of persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia that was successfully treated with combination therapy consisting of high-dose daptomycin (DAP, 10 mg/kg) and rifampicin. The patient's condition was complicated with multiple infectious foci, including an iliopsoas abscess and epidural abscess, as well as discitis and spondylitis at the cervical, thoracic and lumbar levels. Monotherapy treatments with vancomycin, linezolid and usual-dose DAP were all ineffective. It has been shown that usual-dose DAP administration may result in the emergence of a resistant strain and treatment failure. We would like to emphasize the importance of high-dose DAP therapy for MRSA bacteremia, a condition with a potentially high mortality rate.

著者

Yoshiko Yoshida Toshihiro Shirai Masashi Mikamo Yuichiro Shishido Takefumi Akita Satoru Morita Kazuhiro Asada Masato Fujii Takafumi Suda

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.18, pp.2135-2138, 2013 (Released:2013-09-15)

参考文献数

5

被引用文献数

2

---

A 55-year-old woman visited our hospital for an investigation of central bronchiectasis, mucoid impaction and infiltrative shadows on chest CT. She had a 10-year history of bronchial asthma; however, her adherence to treatment was poor. Based on the presence of peripheral blood eosinophilia and immediate cutaneous reactivity to Aspergillus fumigatus, the patient was clinically diagnosed with allergic bronchopulmonary aspergillosis. Her condition and CT findings improved with systemic corticosteroid therapy. It was found that the patient had not been sensitized to Aspergillus 10 years earlier, indicating that single testing is inadequate for the early diagnosis of this disease.

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

Yoshinao Yazaki Kazuhiro Satomi Taishiro Chikamori

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.61, no.11, pp.1645-1651, 2022-06-01 (Released:2022-06-01)

参考文献数

8

被引用文献数

1

---

Objective The Lewis lead configuration is an alternative bipolar chest lead and it can help detect atrial activity. The utility of the Lewis lead to distinguish orthodromic atrioventricular reentrant tachycardia (AVRT) from typical atrioventricular nodal reentrant tachycardia (AVNRT) by visualizing the apparent retrogradely conducted P waves was investigated. Methods Forty-four patients with paroxysmal supraventricular tachycardia (PSVT) were included in this study. All patients had PSVT documented by an electrocardiogram (ECG) and underwent an electrophysiological study (EPS). During tachycardia, an ECG recording was performed using a Lewis lead with the electrode on the right aspect of the sternum at the second intercostal space instead of the right arm and the electrode on the fourth intercostal space instead of the left arm. The ECG parameters during tachycardia were compared between AVRT and AVNRT. Results Fourteen patients were diagnosed with AVRTs and 30 with typical AVNRTs on EPS. The positive P wave could be seen in the Lewis lead configuration in 9 of 14 patients with AVRTs and 21 of 30 patients with AVNRTs. P waves were more often visible in the Lewis lead configuration than in the standard leads (66% vs. 45%). The RP interval was significantly longer for AVRTs than for AVNRTs (88±17 vs. 154±34 ms, p<0.001), which yields 89% sensitivity and 71% specificity for distinguishing these 2 tachyarrhythmias with a cut-off point of 100 ms. Conclusion A Lewis lead configuration may help to make an accurate diagnosis among the reentrant supraventricular tachycardias prior to procedures, owing to its ability to locate P waves.

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

vol.57, no.5, pp.707-711, 2018-03-01 (Released:2018-03-01)

参考文献数

23

被引用文献数

6

---

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.

著者

Masayuki Ueda Marie Tsunogae Hiroshi Saito Takeya Suzuki Takahiro Ota

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.5621-20, (Released:2020-09-19)

参考文献数

14

被引用文献数

4

---

A 24-year-old female patient was admitted for a right frontal intracranial hematoma with an uncal herniation due to a ruptured arteriovenous malformation and therefore underwent emergency surgery. Neuroimaging revealed left-sided midbrain notching against the tentorium, indicating Kernohan's notch phenomenon. She denied experiencing any short-term neurological deficits but right-sided delayed hemiparkinsonism developed 18 months later. Dopamine transporter tracer uptake was severely reduced in the left striatum, suggesting nigrostriatal degeneration secondary to Kernohan's notch. Uncal herniations are potentially fatal, but surgery can save the patient's life and improve the functional outcomes. Clinicians should therefore be aware of delayed hemiparkinsonism as a rare complication of Kernohan's notch phenomenon.

著者

Shunsuke Ogata Yoshito Ishii Keiichiro Asano Erena Kobayashi Shun Kubota Keita Takahashi Yosuke Miyaji Yuichi Higashiyama Hideto Joki Hiroshi Doi Michiaki Koga Hideyuki Takeuchi Fumiaki Tanaka

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.61, no.11, pp.1757-1760, 2022-06-01 (Released:2022-06-01)

参考文献数

9

被引用文献数

10

---

Guillain-Barré syndrome (GBS) has occasionally occurred in people who have received coronavirus disease 2019 (COVID-19) vaccines. Dysgeusia is rare symptom of GBS. We herein report a rare case of sensory ataxic GBS with dysgeusia just after the second dose of the Pfizer-BioNTech COVID-19 vaccine. Although autoantibodies against glycolipids were not detected, immunotherapy with intravenous immunoglobulin and methylprednisolone pulse therapy effectively ameliorated the symptoms. Our report suggests that the COVID-19 vaccine may induce various clinical subtypes of GBS, including a rare variant with sensory ataxia and dysgeusia.

著者

Shunsuke Yamada Kanako Yamada Hiroshi Nishida

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.61, no.19, pp.2995, 2022-10-01 (Released:2022-10-01)

参考文献数

4

被引用文献数

5

著者

Atsuko Uehara Yohei Kita Hirofumi Sumi Yugo Shibagaki

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.58, no.15, pp.2201-2205, 2019-08-01 (Released:2019-08-01)

参考文献数

21

被引用文献数

8 13

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Hypomagnesemia, a side effect of proton-pump inhibitors (PPIs), can be asymptomatic. The presence of hypocalcemia or hypokalemia is indicative of hypomagnesemia; however, the concomitant use of PPIs and thiazide may mask hypocalcemia. A 79-year-old woman with a history of chronic heart failure and chronic kidney disease developed symptomatic hypocalcemia and hypomagnesemia. Five weeks earlier, she had developed thiazide-induced hyponatremia, so thiazide had been discontinued. Reviewing the patient's charts revealed that three discontinued thiazide administrations in the clinical course had unmasked hypocalcemia. Our case demonstrates that thiazide-induced hypercalcemia can be so prominent as to mask PPI-induced hypocalcemia and hypomagnesemia.

著者

Teruhisa Kinoshita Shoko Sahara Tomomi Amano Masashi Ito Takashi Sakakibara Norio Takimoto Yukari Osada Keisuke Oka

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.1141-22, (Released:2023-02-22)

参考文献数

14

被引用文献数

1

---

We herein report a case of peritoneal dialysis-associated peritonitis caused by Lysinibacillus sphaericus in a 40s-year-old patient. Treatment was initiated with intermittent intraperitoneal cefazolin and ceftazidime. Later, both peritoneal dialysate and blood cultures detected L. sphaericus, so the antibiotic was changed to ampicillin (ABPC). The patient was treated with a combination of intraperitoneal intermittent and intravenous ABPC for 7 days, followed by 14 days of amoxicillin. The patient experienced no adverse events and no recurrence for 30 days. The patient had four dogs, and the infection was deemed likely to have been caused by environmental contamination and inadequate catheter replacement.