感染症学雑誌
Online ISSN : 1884-569X
Print ISSN : 0387-5911
症例
多彩な頭頸部病変を呈した Peptostreptococcus micros による敗血症性肺塞栓症の 1 例
生方 智神宮 大輔矢島 剛洋庄司 淳高橋 洋
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ジャーナル フリー

2013 年 87 巻 6 号 p. 761-766

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A 46-year-old man with no underlying diseases visited our hospital with otorrhea, ocular motility disorder of the left eye, dizziness and loss of appetite which had lasted for two months. Chest radiography and computed tomography (CT) showed bilateral multiple pulmonary nodules and cavities. Furthermore, CT of the head and neck revealed bilateral mastoiditis, a left orbital abscess and a deep neck abscess. Peptostreptococcus micros was cultured from blood and otorrhea specimens. In addition, P. micros DNA was detected with the polymerase chain reaction (PCR) method in the specimens from the site of culture-negative lesions (i.e. sputum, bronchoalveolar lavage, neck abscess). Thus, we diagnosed the lung lesions as septic pulmonary embolisms (SPEs). The clinical findings of the head and neck had improved following antibiotics treatment for five weeks, and follow-up chest radiography and CT showed that all lesions almost disappeared. Since some SPE patients demonstrate a slow progression, SPE should be included in the differential diagnosis of multiple pulmonary nodules such as Wegenerʼs glanulomatosis or neoplasm.

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© 2013 社団法人 日本感染症学会
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