We examined the history of food allergy （FA） in patients at the University of Yamanashi Hospital who were hospitalized from 2019 to 2021 and developed allergic transfusion reactions （ATRs）. One hundred fifty-seven patients developed mild ATRs, among which 22 patients had a history of FA. Out of the 157 patients, 30 patients received red blood cell （RBC） transfusion, among which 20.0% （6/30） had FA. Thirty patients received fresh frozen plasma （FFP） transfusion, and 23.3% （7/30） of them had FA. Ninety-seven patients received platelet concentrate （PC） transfusion, and 9.3% （9/97） of them had FA. The FA history-positive rate was 21.7% （13/60） in patients who developed mild ATRs after RBC or FFP transfusion, which was significantly higher than that （11.1%, 4,380/39,473） in all patients hospitalized and that in patients without any adverse transfusion reactions （3.1%） during the same periods. We suggest the possibility that allergic food antigens included in blood products might partly （maximally 10%） be involved in the occurrence of mild ATRs after RBC or FFP transfusion. Despite the higher incidence of ATRs after PC transfusion, the involvement of FA was not demonstrated probably because more multimodal factors are implicated in ATRs after PC transfusion.

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  We present a possibly unique autopsy case of fatal aortopulmonary fistula associated with subclinical infectious aortitis in an elderly man. After 6-week antifungal therapy for candidiasis in his eyes accompanying leakage from anastomoses following gastrectomy, β-D-glucan levels remained elevated despite negative blood cultures. Six weeks after completion of the antifungal therapy, he was re-hospitalized for hematochezia possibly due to bleeding associated with the anastomosis sites, and arterial embolization was successfully performed. However, about three weeks after the embolization, he died of hemorrhagic shock due to sudden bloody “vomiting”. Autopsy revealed no anastomosis-related bleeding but an unexpected non-aneurysmal Candidal aortitis-related aortopulmonary fistula. This had caused massive fatal hemorrhage into the lung parenchyma and resultant bloody “vomiting”. We believe that the long-standing elevated β-D-glucan level, even with negative blood culture results, may indicate subclinical fungal aortitis. This may have directly contributed to our patient’s death, although such a fatal event may be rare.

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Aims: Bacteroides fragilis is the most common anaerobic bacteria causing infectious diseases in humans. A cfiA gene encoding metallo- β-lactamase, which degrades carbapenem, has been reported as a resistance mechanism against carbapenem. Therefore, the detection of cfiA gene is important for determining appropriate antibiotic therapy. Although cfiA gene is detected via polymerase chain reaction (PCR), simpler and easier methods are required in clinical settings. We compared the detectability of cfiA-positive B. fragilis using multiple methods. Moreover, the isolation frequency of carbapenem-nonsusceptible Bacteroides spp. was evaluated.
Methods: Bacteroides spp. was isolated from clinical specimens at the Kanazawa University Hospital. Antimicrobial susceptibility testing was performed via broth microdilution. We explored whether matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) and modified carbapenem inactivation method (mCIM) can show cfiA gene positivity.
Results: Around 20-50 Bacteroides spp. strains/year were isolated from June 2015 to December 2020. Among these, 0-8 strains exhibited meropenem and/or imipenem nonsusceptibility (intermediate and resistant) in each year. An increased rate of carbapenem resistance, including meropenem- and imipenem-nonsusceptible Bacteroides spp., was observed. All carbapenem-nonsusceptible Bacteroides spp. were susceptible to metronidazole. Four (66.7%) of 6 strains showed cfiA gene positivity based on PCR.
Conclusions: MALDI-TOF MS and mCIM detected cfiA-positive strains. MALDI-TOF MS and mCIM are useful for detecting cfiA-positive B. fragilis. Because the isolation frequency of carbapenem-nonsusceptible Bacteroides spp. is increasing, determining their susceptibility is important for appropriate antimicrobial therapy.

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Objective: This study aims to address the challenges of identifying Diploscapter coronatus by morphological and genetic analysis. The nematode was previously identified morphologically in fecal samples from a patient with Henoch-Schönlein purpura. We used genetic methods to complement and refine species identification.
Materials and Methods: Nematodes isolated from the patient’s feces were fixed in formalin, and morphological observations were made under a light microscope. PCR amplification of the SSU rRNA and Hsp90 genes was performed on DNA extracted from the nematodes during the same period. The resulting DNA was cloned, sequenced, and subjected to phylogenetic analysis using the neighbor-joining method.
Results: Morphological observations confirmed that the nematode shared key features with D. coronatus. The SSU rRNA analysis showed 99% similarity with 11 Diploscapter species, including D. coronatus. However, Hsp90 gene analysis placed the nematode in the D. lycostoma cluster, revealing inconsistencies between morphological and genetic data.
Conclusion: The present study highlights the complexity of species identification within the genus Diploscapter that results from the limited genetic information and overlapping morphological characters. The results underscore the need for more extensive genetic data and comprehensive phylogenetic analyses to resolve these identification challenges and better understand species relationships within the genus.

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