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Volume 78, Issue 12
Displaying 1-8 of 8 articles from this issue
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Yoriko KOSUGI, Takatoshi ISHIKAWA, Yuri CHIMURA, Megumi ANNAKA, Sumie ...2004 Volume 78 Issue 12 Pages 995-999
Published: December 20, 2004
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSInfluenza can spread rapidly to patients and staff in hospitals when influenza is introduced by visitors, staff, or patients. In order to prevent and control outbreaks of influenza in hospitals, systematic management is important. This consists of a rapid diagnostic test, cohort isolation and administration of neuraminidase inhibitor. In the 2002-2003 season, 53 elderly patients were admitted to our hospital under the control of the system. The mean age was 78.8 years. We set 2 isolation rooms (10 beds) for influenza patients. Patients were isolated in the room for three days, administered oseltamivir immediately. Oral oseltamivir was well tolerated. Mean hospital stay was 10.7 days. 36 cases developed complications requiring antibiotics, and one patient developed a catheter related infection. Under the system, we could avoid cross infection of influenza. In two cases, nose swabs were taken for virus isolation every 12 hours and a rapid decline in virus shedding was observed after treatment.View full abstractDownload PDF (1044K) -
Junko ISOBE, Keiko KIMATA, Masahiro SHIMOJIMA, Shiho HOSOROGI, Daisuke ...2004 Volume 78 Issue 12 Pages 1000-1005
Published: December 20, 2004
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSShiga-like-toxin-producing Esherichia coli O128: HNM were isolated from feces of a one-year-old boy with diarrhea and abdominal pain on July, 2002, and a 11-month-old girl with diarrhea and fever on June, 1997. None of other enteropathogenic bacteria including Salmonella were isolated. E. coli O128: HNM isolates from both patients carry stx2f and eaeA gene, but not stx1, stx2, aggR, bfpA, esth, estp, invE, astA, ureC and hlyA gene. As far as we know, this may be the first report indicating that E. coli O128: HNM carrying stx2f gene were isolated from patients in Japan.View full abstractDownload PDF (2846K) -
Comparison after DecadeToshio SHIMIZU, Hitomi TATEISHI, Ahmed SHERIN, Fusao OTA2004 Volume 78 Issue 12 Pages 1006-1015
Published: December 20, 2004
Released on J-STAGE: May 20, 2011
JOURNAL FREE ACCESSSixty two strains of Group A streptococcus were isolated between August 2001 and June 2002. They were examined for T serotypes, pyrogenic exotoxin genes and resistance against antibiotics. The results were compared with those for 61 isolates of the same species collected between April and December 1991.
Among the strains isolated in 1991, T4 was the dominant serotype (18 strains) followed by T12 and T1 (each 15 strains). These three serotypes represented 78.7% of the total number. In contrast, among the strains isolated in 2001 and 2002 T28 (13 strains) was the dominant serotype followed by T1 (12 strains) and T4 (7 strains). Examination of these isolates for pyrogenic exotoxin gene revealed that all carried speB and more than half of the strains isolated in 1991, 2001 and 2002 carried both speB and speC.
Regarding the combination of T type and toxin genotype, out of the isolates in 1991 fifteen T4 strains were associated with B and C, eleven T12 types with B and C, and nine T1 strains with A and B, while out of the strains isolated in 2001 and 2002 eleven T28 strains were associated with B and C, six T1 strains with B and C, and both five T4 and T12 types with B and C.
Sma I Pulsed-field gel electrophorasis analysis revealed that PFGE patterns of T4: spe B and C and T12: spe B and C strains in 2001 and 2002 are same as one of those in 1991, respectively.
On the other hand, during the decade strains resistant to macrolide increased from 1 strain (1.6%) to 11 strains (17.7%) and those to tetracycline increased from 23 strains (37.7%) to 32 strains (41.6%). During the same period the incidence of multiple resistance increased from 9 strains (14.7%) to 14 strains (22.5%).View full abstractDownload PDF (3296K) -
Eiji YOKOYAMA, Seiichi TSURUOKA, Yoshiko SAITOU, Sadato ICHINOHE2004 Volume 78 Issue 12 Pages 1016-1019
Published: December 20, 2004
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSWe are reporting a case of sealed rupture of thoracoabdominal aortic aneurysm associated with the isolation of Listeria monocytogenes. The patient was a 75-year-old man with previous history of hypertension that had not required medication for the 3 years prior to hospital admission. He was admitted due to chest pain, but he was afebrile. There were no clinical findings indicating infection, although CRP was slightly elevated. During his clinical course, a sealed rupture of a thoracoabdominal aortic aneurysm was found and replaced with an artificial artery. After surgery, he was treated for 2 weeks with sultamicillin. He was discharged from hospital on the 43rd postoperative day. No bacteria were observed after microscopic examination of gram stained samples from the thrombus that was present in the sealed rupture of the aneurysm. However, a L. monocytogenes strain isolated from the thrombus only after enrichment culturing by HK medium at 37°C for 4 days. By histopathology, there was a slight cellular infiltration of lymphocytes and neutrophils at the aperture of the aneurysm. Although L. monocytogenes strains possess major pathogenic genes, such as prfA, hlyA, plcA, plcB, mpl, inlA, inlB and actA that can be identified by PCR, none of the evidence indicated that this case was a mycotic aortic aneurysm due to L. monocytogenes.View full abstractDownload PDF (4268K) -
Wakako HARADA, Masao KUWABARA, Masaru KUWAYAMA, Shinichi TAKAO, Kazuo ...2004 Volume 78 Issue 12 Pages 1020-1025
Published: December 20, 2004
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSWe discussed the clinical features of 5 Japanese encephalitis (JE) cases which we experienced in 2002.
Today there are few opportunities for a clinician to see JE patients. Until the 1950s, the number of JE patients was more than 2000 in Japan, but the annual cases of JE are decreasing remarkably due to the extermination of mosquitoes, thorough vaccination and improvement of environmental sanitation.
However, even today the disease still has a high fatality rate. In fact 4 in 5 cases we experienced had poor prognosis and one of them resulted in death despite the relatively early diagnosis. It shows the difficulty of diagnosis and treatment.
When we see elderly patients with high fever, headache, and impaired consciousness in late summer and autumn, the important thing is to recognize the possibility of JE. Moreover it turned out that brain MRI and detecting serologic JE virus antibodies was very helpful for diagnosis and treatment.
Nowadays we clinicians tend to consider JE as a disease of the past in Japan, however, this experience taught us that it is necessary for us to study JE again and to continue educating the public about it.View full abstractDownload PDF (5646K) -
Isao NAKAMURA, Masako KUNIHIRO, Haru KATO2004 Volume 78 Issue 12 Pages 1026-1030
Published: December 20, 2004
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSWe describe a case of bacteremia due to Clostridium difficile, which was successfully treated by intravenous vancomycin.
A 69-year-old woman was admitted to our hospital because of third degree burn injuries. She was treated with cefazolin for two weeks followed with flomoxef for one week before the operation (debridement and grafting of skin). On the third postoperative day high fever (temperature 40°C), abdominal pain and severe watery diarrhea developed. Antibiotic-associated colitis with bacteremia was diagnosed presumptively, flomoxef was stopped, and oral and intravenous therapy with vancomycin was started. A blood culture taken before the administration of vancomycin yielded C. difficile accompanied with Enterococcus faecalis and Enetrococcus casseliflavus. A stool culture taken on the next day yielded C. difficile, and a stool latex agglutination test was also positive. The patient improved slowly. Parenteral vancomycin was discontinued after two weeks. One week later, the patient developed pneumonia, and imipenem/cilastatin was added. Soon after addition of the agent, she developed recurrent diarrhea despite continual oral vancomycin therapy. The fecal samples obtained at this time were positive for C. difficile by culture and positive for toxins A & B. She was satisfactorily treated with oral vancomycin for a total of four weeks. After the following two weeks, however, recurrencee of diarrhea developed again, which rapidly decreased with oral vancomycin for seven days. The patient did well thereafter and was discharged.
All three C. difficile isolates from blood and fecal specimens were positive for toxins A & B, and identified the same PCR ribotyping pattern.View full abstractDownload PDF (1872K) -
Yoshifumi UNO2004 Volume 78 Issue 12 Pages 1031-1035
Published: December 20, 2004
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSA 10-year-old male demonstrating otitis media with effusion by Mycoplasma pneumoniae is reported. The patient was brought to my hospital because of hearing disturbance. β-lactam antibiotics were not effective and we performed a tympanotomy. Microbacterial materials were obtained from the middle ear effusion and nasopharynx. Mycoplasma pneumoniae was detected by the PCR method from both materials and antibody to Mycoplasema pneumoniae was also detected. It is very rare for otitis media with effusion due to Mycoplasma pneumoniae to occur without pneumonia. It is reported that some cases of otitis media with effusion have demonstrated good results by long-term low-dosemacrolide therapy. We believe some of these cases were caused by Mycoplaema pneumoniae.View full abstractDownload PDF (2206K) -
Masatoshi TOKOJIMA, Jun-ichi ASHITANI, Masamitsu NAKAZATO2004 Volume 78 Issue 12 Pages 1036-1040
Published: December 20, 2004
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSA 50-year-old male, living in the rural distinct of Kagoshima Prefecture complained of high fever and fatigue. Chest X-ray showed ground glass opacities in the right lung field. His symptoms and radiographic findings were gradually improved by intravenous or per os administraions of some antibiotics intravenously or per os. Following the chest computed tomography one month later demonstrated ground glass opacities in the right lung field. Examinations of peripheral blood showed increased IgE level but no eosinophila. Bronchoalveolar lavage fluid obtained from B4 showed high proportion of eosinophils. Because of the positive finding for Ascaris suum in the assay of multi dot-ELISA for parasite, he was diagnosed as Ascaris suum infection. The patient was successfully treated with Alvendazol. This is a rare case of Ascaris suum infection causing eosinophilic pneumonia.View full abstractDownload PDF (4521K)
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