感染症学雑誌
Online ISSN : 1884-569X
Print ISSN : 0387-5911
ISSN-L : 0387-5911
症例
急性骨髄性白血病に合併し,血中プロカルシトニンが高値を示した アメーバ性大腸炎・肝膿瘍
奥 英二郎野村 桂中村 剛之森重 聡関 律子今村 理恵橋口 道俊大崎 浩一水野 晋一長藤 宏司岡村 孝
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ジャーナル フリー

2012 年 86 巻 6 号 p. 773-777

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We present a case of amebic colitis and liver abscess complicated by acute myeloid leukemia (AML) with high serum procalcitonin (PCT). A 61-year-old Japanese man seen at our hospital for severe diarrhea and high fever was found to have multiple ulcers in the transverse and sigmoid colon and rectum by colonoscopy and biopsies were conducted. Immature leukocytes with mild anemia and thrombocytopenia were seen in peripheral blood, necessitating bone marrow aspiration and biopsy that yielded a diagnosis of AML (FAB M4Eo). Serum C-reactive protein and PCT were extremely elevated. Blood cultures for bacteria and fungi were negative. Multiple low-density areas in the liver were found in abdominal computed tomography. Histological colon biopsy findings revealed amebic colitis, strongly suggesting amebic liver abscess. Metronidazole treatment was initiated for amebiasis and subsequent standard chemotherapy for AML was followed after fever was lowered. Hematological and cytogenetic CR was maintained with good clinical condition. Few case reports have been published in Japan to date on amebic colitis and liver abscess complicated by AML and no reports have been made on PCT elevation caused by amebiasis. In conclusion, differential diagnosis of amebiasis is necessary in addition to that of bacterial or fungal infection in serum PCT elevation.

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© 2012 社団法人 日本感染症学会
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