セキ　マサフミ   SEK Masafumi   関　雅文    所属   埼玉医科大学  医学部 国際医療センター　感染症科・感染制御科    職種   教授
論文種別	学術雑誌(原著)
言語種別	英語
査読の有無	査読なし
表題	A patient with fulminant influenza-related bacterial pneumonia due to Streptococcus pneumoniae followed by Mycobacterium tuberculosis infection.
掲載誌名	正式名：Internal medicine (Tokyo, Japan) ISSNコード：09182918
巻・号・頁	47(23),2043-7頁
著者・共著者	Masafumi Seki,Naofumi Suyama,Kohji Hashiguchi,Atsuko Hara,Kosuke Kosai,Shintaro Kurihara,Shigeki Nakamura,Kazuko Yamamoto,Yoshifumi Imamura,Koichi Izumikawa,Hiroshi Kakaya,Katsunori Yanagihara,Yoshihiro Yamamoto,Hiroshi Mukae,Takayoshi Tashiro,Shigeru Kohno
発行年月	2008
概要	A 74-year-old man with poorly controlled diabetes mellitus was admitted to our hospital because of severe respiratory disturbance, fever, and sputum. We found massive consolidation of the right lung and nodular shadows on the left lung on chest X-ray, and detected influenza virus and Streptococcus pneumoniae antigen from a nasopharyngeal swab and urine sample, respectively. Co-infection with influenza virus and bacteria was suspected, and oseltamivir and biapenem were prescribed. Laboratory data improved after the addition of sivelestat sodium hydrate, an inhibitor of neutrophil-derived elastase; however, chest X-ray findings became worse on Day 8, and we administered 1 g methylprednisolone intravenously for two days. On Day 12, we detected Mycobacterium tuberculosis in the sputum, even though we did not previously detect any acid-fast bacilli, and started anti-tuberculosis drugs, such as isoniazid, rifampicin, ethambutol hydrochloride, and pyrazinamide; however, the patient died 12 days later. Severe influenza-related bacterial pneumonia with Streptococcus pneumoniae and subsequently secondary tuberculosis infection were finally suspected in this case. This was a very rare case in
DOI	10.2169/internalmedicine.47.1473
NAID	130000079798
PMID	19043258