Abstract
A 37-year-old woman was admitted to our hospital with severe hypokalemia and emaciation manifested by 11.2 of body mass index. She had the habit of self-induced vomiting and laxative use for 16 years and was diagnosed as eating disorder. Despite intravenous drip infusion and nutritional support, fever and dyspnea appeared on the 7th hospital day. Chest X-ray and computed tomography revealed bilateral pulmonary infiltration shadows and pleural effusion. Bacterial culture of the peripheral blood detected Bacillus cereus. Oxygenation had been getting worse gradually and the patient was diagnosed as adult respiratory distress syndrome (ARDS) based on Bacillus cereus sepsis. She received intensive care including ventilatory support, administration of neutrophil elastase inhibitor and antibiotics. After 3 days, her condition improved and she was weaned from ventilator. Although she had a poor insight into abnormality of eating with resistance to psychotherapy at first, experience of life-threatening condition changed her motivation to improve nutrition. She discharged with 13.7 of body mass index after the hospitalization for 3 months. The present case suggests that commensal bacteria-induced sepsis may cause ARDS in patients with eating disorder and that a near fatal experience may change the motivation for treatment.
