The Medical Journal of Matsue City Hospital

A 67-year-old female patient complained of left lower abdominal pain and was transferred to our hospital. Though a plain abdominal X-ray showed of no sign of free air, but abdominal CT study revealed the intraperitoneal air. She underwent emergent laparotomy in the diagnosis of sigmoidal perforation. A perforation, about 3cm in diameter, was found longitually on the mesenteric side of sigmoid colon. She was operated by the method of Hartmann having the perforated colon removed. Patho-histological findings revealed the rupture of the diverticulm of the sigmoid colon. The post-operative course was uneventful.

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A 61-year-old woman presented with a rare case of primary intrinsic brainstem oligodendroglioma. The patient developed prolonged dizziness and nausea, after an episode of vertigo. Neuroimaging demonstrated a homogeneous pontomedullary mass with an exophytic growth toward the fourth ventricle. The tumnor was diagnosed as a brainstem glioma. The tumor, however, grew so rapidly that the biopsy was performed through a suboccipital craniotomy. Histological examination revealed as the diagnosis of oligoderndroglioma. The patient was treated with radiation and temozolomide. The growth of the tumor is controlled for months.

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　A 18-year-old female high school student visited our hospital with complaints of a sustained fever ranging between 39℃ and 40℃. She had stayed for one week at a hotel in Osaka in February 2008. She had never been abroad in her life. At the time of her first visit, we diagnosed that she might be suffering from some type of acute viral infection and admitted her to the hospital for medical observation. Blistering fever continued in spite of antibiotics medication, we did two sets of blood culture tests following upon a 48 hours’ interruption of the antibiotics therapy. The sample of one blood culture proved the presence of Salmonella Typhi. We administered the Pazufloxacin antibiotic drug intravenously for three days and the Levofloxacin orally for two weeks. She began to feel better after the treatment and it was determined that she no longer carried any typhoid bacteria after a double stool culture test. In Japan, from 50 to 80 cases of typhoid fever occur each year, and about 80% of these are acquired while traveling abroad. Because cases of typhoid fever are currently uncommon in Japan, we report this domestic case of typhoid fever at our hospital.

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