日本救急医学会雑誌
Online ISSN : 1883-3772
Print ISSN : 0915-924X
ISSN-L : 0915-924X
人工呼吸管理を要した重症オウム病の1治験例
千保 純一郎浜崎 正行堀越 淳大石 知実内 孝斉藤 徹上嶋 権兵衛
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1992 年 3 巻 2 号 p. 83-87

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A 39-year-old woman was admitted with complaints of fever and severe dyspnea. Chest X-ray revealed bilateral widespread opacity with glass shadow. In addition arterial blood gas analysis revealed severe hypoxemia (PaO2 44.1mmHg, 100% mask). On the day of admission, she was intubated and ventilated mechanically with FiO2 1.0, PEEP 10cm H2O. Subsequently, treatment with intravenous minocycline (200mg/day) was started. The abnormal chest X-ray findings and hypoxemia improved by day 5. On the 12th day of her hospital stay, she was successfully weaned from the ventilator. Analysis of complement fixation antibodies against Chlamydia showed a significant rise, 1:128. The titer of IgM antibodies to Chlamydia psittaci by the microplate immunofluorescent antibody technique was 20 (normal:10>). This disease was considered to be acute pneumonia due to fulminant psittacosis causing acute respiratory failure. Psittacosis should always be borne in mind as a possible cause of fulminant pneumonia with acute respiratory failure, and such a situation can be handled successfully if emergency care including mechanical ventilation is available.
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