JaLCDOI 10.18926/AMO/55861
FullText URL 72_2_189.pdf
Author Nakao, Shinichiro| Hagiya, Hideharu| Kimura, Keigo| Mitsui, Tomomi| Oyama, Akane| Hongyo, Kazuhiro| Takahashi, Yusuke| Nakagami, Futoshi| Tomono, Kazunori| Rakugi, Hiromi|
Abstract A 65-year-old Japanese man with bilateral carotid atherosclerosis presented with right neck pain and fever. Contrast-enhanced computed tomography suggested carotid arteritis, and carotid ultrasonography showed an unstable plaque. The patient developed a cerebral embolism, causing a transient ischemic attack. Helicobacter cinaedi was detected in blood culture, and H. cinaedi-associated carotid arteritis was diagnosed. Empirical antibiotic therapy was administered for 6 weeks. After readmission for recurrent fever, he was treated another 8 weeks. Although the relationship between H. cinaedi infection and atherosclerosis development remains unclear, the atherosclerotic changes in our patient’s carotid artery might have been attributable to H. cinaedi infection.
Keywords atherosclerosis bacteremia bacterial translocation Helicobacter cinaedi vascular infection
Amo Type Case Report
Published Date 2018-04
Publication Title Acta Medica Okayama
Volume volume72
Issue issue2
Publisher Okayama University Medical School
Start Page 189
End Page 192
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2018 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29674769
JaLCDOI 10.18926/AMO/54977
FullText URL 71_2_97.pdf
Author Iwamuro, Masaya| Kondo, Eisei| Tanaka, Takehiro| Hagiya, Hideharu| Kawano, Seiji| Kawahara, Yoshiro| Otsuka, Fumio| Okada, Hiroyuki|
Abstract We retrospectively analyzed the cases of 14 patients (9 women, 5 men, mean age: 51.6 years) with cytomegalovirus (CMV) involvement in the esophagus, stomach, and/or duodenum diagnosed at a single center, to determine their endoscopic features and clinical backgrounds. Thirteen patients (92.9%) had hematologic disease; the other had rheumatoid arthritis. Of the former, 12 patients underwent allogeneic hematopoietic stem cell transplantation, and 9 of these patients had graft-versus-host disease (GVHD) before undergoing esophagogastroduodenoscopy (EGD). All 14 patients had been taking one or more immunosuppressive agents including cyclosporine (n=10), corticosteroids (n=9), mycophenolic acid (n=6), tacrolimus (n=3), and methotrexate (n=1). Tests for CMV antigenemia were positive in 11 patients (78.6%). EGD examinations revealed esophageal (n=3), gastric (n=9), and duodenal involvement (n=6). Macroscopically, esophageal lesions by CMV infection presented as redness (n=1), erosions (n=1), and ulcers (n=1). Gastric lesions manifested as redness (n=7), erosions (n=3), exfoliated mucosa (n=2), and verrucous erosions (n=1). Mucosal appearances in the duodenum varied: redness (n=2), ulcers (n=2), multiple erosions (n=2), single erosion (n=1), edema (n=1). CMV was detected even in the intact duodenal mucosa (n=1). In conclusion, physicians must recall the relevance of CMV infection when any mucosal alterations exist in the upper gastrointestinal tract of immunosuppressed patients.
Keywords cytomegalovirus duodenum esophagogastroduodenoscopy esophagus stomach
Amo Type Original Article
Published Date 2017-04
Publication Title Acta Medica Okayama
Volume volume71
Issue issue2
Publisher Okayama University Medical School
Start Page 97
End Page 104
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 28420890
JaLCDOI 10.18926/AMO/54597
FullText URL 70_5_383.pdf
Author Nishiwaki, Masatake| Hagiya, Hideharu| Kamiya, Toru|
Abstract Kikuchi-Fujimoto disease (KFD) is a benign cause of self-limiting subacute necrotizing lymphadenitis. KFD is rarely complicated with reactive hemophagocytic lymphohistiocytosis (HLH), and the clinical features of the simultaneous occurrence of these conditions are uncertain. A 30-year-old Japanese man with a persistent fever and sore throat presented to our hospital for treatment. Laboratory analysis showed bicytopenia, and radiological studies showed systemic lymphadenopathy accompanied by splenomegaly. A bone marrow examination showed hemophagocytic macrophages, suggesting HLH. Malignant lymphoma was suspected as a possible underlying disease, but the histology of the lymph nodes led to a final diagnosis of KFD and treatment with prednisolone (1 mg/kg/day), resulting in clinical improvement. This case highlighted the importance and difficulty of differentiating KFD from malignant lymphoma as an underlying condition of HLH. The literature review showed that patients with HLH-associated KFD may have higher serum ferritin and lactate dehydrogenase levels compared to typical KFD cases. Definite diagnosis based on pathological examination is essential for a better understanding of this rare disease. The presence of systemic lymphadenopathy does not exclude the possibility of KFD. This case serves to remind physicians that KFD is a potential etiology of HLH.
Keywords hemophagocytic lymphohistiocytosis hemophagocytic syndrome histiocytic necrotizing lymphadenitis Kikuchi disease Kikuchi-Fujimoto disease
Amo Type Case Reports
Published Date 2016-10
Publication Title Acta Medica Okayama
Volume volume70
Issue issue5
Publisher Okayama University Medical School
Start Page 383
End Page 388
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27777431
Web of Sience KeyUT 000388098700008
JaLCDOI 10.18926/AMO/53679
FullText URL 69_5_319.pdf
Author Hagiya, Hideharu| Iwamuro, Masaya| Tanaka, Takehiro| Hanayama, Yoshihisa| Otsuka, Fumio|
Abstract A 60-year-old woman with rheumatoid arthritis treated with methotrexate for a decade complained of slight epigastric discomfort. A positive cytomegalovirus (CMV) antigenemia test indicated the probability of CMV-related gastrointestinal infection, for which esophagogastroduodenoscopy was performed. Endoscopic findings showed a non-specific duodenal mucosal lesion;however, pathological investigation revealed evidence of CMV duodenitis. There is scarce information on the clinical and pathological features of CMV-related duodenitis, likely due to its low prevalence. CMV infection in the upper gastrointestinal tract should be considered as a differential diagnosis in high-risk individuals, particularly those with symptoms relating to the digestive system. Biopsy examinations are preferable for the definitive diagnosis of CMV gastrointestinal infection, even without specific endoscopic features.
Keywords antigenemia cytomegalovirus (CMV) gastrointestinal infection methotrexate opportunistic infection
Amo Type Case Report
Published Date 2015-10
Publication Title Acta Medica Okayama
Volume volume69
Issue issue5
Publisher Okayama University Medical School
Start Page 319
End Page 323
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2015 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 26490030
Web of Sience KeyUT 000365519600009
JaLCDOI 10.18926/AMO/53342
FullText URL 69_2_123.pdf
Author Waseda, Koichi| Hagiya, Hideharu| Hanayama, Yoshihisa| Terasaka, Tomohiro| Kimura, Kosuke| Tsuzuki, Takao| Hasegawa, Kou| Nada, Takahiro| Nakamura, Eri| Murakami, Kazutoshi| Kondo, Eisei| Otsuka, Fumio|
Abstract An 81-year-old Japanese male with primary Sjögren syndrome (pSS) developed a low-grade fever and productive cough which were refractory to antibiotic therapy. Based on the high level of eosinophils observed in his bronchial alveolar lavage, he was diagnosed with chronic eosinophilic pneumonia (CEP) and successfully treated by oral prednisolone. Interstitial lung diseases associated with pSS (pSS-ILDs) usually present as nonspecific interstitial pneumonia or usual interstitial pneumonia; therefore, the present case is extremely unique in that the patientʼs condition was complicated with CEP. A diagnosis of advanced gallbladder cancer was made in the patientʼs clinical course, suggesting the advisability of a whole-body workup in cases of pSS, especially in elderly patients.
Keywords bronchial alveolar lavage eosinophilic pneumonia eosinophilia interstitial lung diseases Sjögren syndrome
Amo Type Case Report
Published Date 2015-04
Publication Title Acta Medica Okayama
Volume volume69
Issue issue2
Publisher Okayama University Medical School
Start Page 123
End Page 127
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2015 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 25899635
Web of Sience KeyUT 000353181700008
JaLCDOI 10.18926/AMO/53341
FullText URL 69_2_119.pdf
Author Terasaka, Tomohiro| Hagiya, Hideharu| Kimura, Kosuke| Nada, Takahiro| Nakamura, Eri| Hanayama, Yoshihisa| Sugiyama, Hitoshi| Kobayashi, Yasuyuki| Yanai, Hiroyuki| Otsuka, Fumio|
Abstract We report the case of a 46-year-old hypertensive Japanese female with renal insufficiency related to unilateral renal hypoplasia. The patient was found to have developed paraganglioma in the retroperitoneal space over a 5-year period. Catecholamine-producing tumors are not usually recognized as conditions associated with renal hypoplasia. Our long-term observation of the patient eventually led us to the diagnosis of paraganglioma. In hypertensive patients with chronic kidney disease, not only the renin-angiotensin-aldosterone system but also catecholamine activity may be involved, particularly in the patients whose cases are complicated with unilateral renal hypoplasia.
Keywords catecholamine paraganglioma renal hypoplasia renovascular hypertension secondary hypertension
Amo Type Case Report
Published Date 2015-04
Publication Title Acta Medica Okayama
Volume volume69
Issue issue2
Publisher Okayama University Medical School
Start Page 119
End Page 122
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2015 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 25899634
Web of Sience KeyUT 000353181700007
JaLCDOI 10.18926/AMO/52658
FullText URL 68_3_171.pdf
Author Hagiya, Hideharu| Matsumoto, Mitsuaki| Yamasawa, Takahiko| Haruki, Yuto| Otsuka, Fumio|
Abstract A 79-year-old man who had undergone a right femoropopliteal (FP) bypass operation 6 weeks previously was diagnosed with vascular graft infection caused by Staphylococcus lugdunensis. Another FP bypass operation was performed, with long-term administration of antibiotics, and the patient eventually recovered well without any recurrences for over 2 years. Although S. lugdunens is classified as coagulase-negative Staphylococcus, its pathogenicity has been reported to be equal to that of S. aureus. Based on the literature review, the organism characteristically colonizes the inguinal area of human skin;thus, operations such as FP bypass grafting may place patients at a relatively high risk for infection by S. lugdunensis, a potentially high-pathogenicity organism.
Keywords coagulase-negative Staphylococcus (CNS) femoropopliteal (FP) bypass Staphylococcus lugdunensis vacuum-assisted closure (VAC) therapy vascular graft infection (VGI)
Amo Type Case Report
Published Date 2014-06
Publication Title Acta Medica Okayama
Volume volume68
Issue issue3
Publisher Okayama University Medical School
Start Page 171
End Page 175
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 24942796
Web of Sience KeyUT 000337655600007
JaLCDOI 10.18926/AMO/52402
FullText URL 68_2_57.pdf
Author Hagiya, Hideharu| Naito, Hiromichi| Hagioka, Shingo| Okahara, Shuji| Morimoto, Naoki| Kusano, Nobuchika| Otsuka, Fumio|
Abstract The effect of antibiotics during the perioperative period of percutaneous dilatational tracheostomy (PDT) is still controversial. A total of 297 patients who underwent the PDT procedure were divided into 2 groups:those administered antibiotics perioperatively and those not administered antibiotics. Wound infections were noted in 7 cases (incidence rate, 2.36%) and no death was recorded. Of the 69 patients without antibiotics, 5 developed wound infections (incidence rate, 7.25%), while only 2 of the 228 patients with antibiotics developed wound infections (incidence rate, 0.88%) (p=0.002;risk ratio, 8.82;95% confidence interval, 1.67-46.6). Of the 7 cases of wound infection, 5 cases occurred during the early period after PDT (within 7 days). Collectively, the present results suggest that prophylactic administration of antibiotics may prevent the incidence of PDT-induced wound infection, especially in the early phase after the PDT procedures. The need for antibiotics in PDT should be reconsidered.
Keywords airway management critically ill patient percutaneous dilatational tracheostomy surgical site infection
Amo Type Original Article
Published Date 2014-04
Publication Title Acta Medica Okayama
Volume volume68
Issue issue2
Publisher Okayama University Medical School
Start Page 57
End Page 62
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 24743781
Web of Sience KeyUT 000334652700001