胃癌術後に肺炎球菌による脾摘後重症感染症を発症した1例

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  • Overwhelming postsplenectomy infection (opsi) in a patient who had undergone gastrectomy—report of a case—
  • ショウレイ イガン ジュツゴ ニ ハイエン キュウキン ニ ヨル ヒテキゴ ジュウショウ カンセンショウ オ ハッショウ シタ 1レイ

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A 76-year-old woman who had undergone splenectomy combined with total gastrectomy for advanced gastric cancer was admitted to our hospital because of high fever, dehydration and mental confusion 10 months after surgery. The patient began receiving antibiotics, intravenous immunoglobulin, and thrombomojulin for disseminated intravascular coagulation.<BR>The result of blood culture revealed sepsis due to Streptococcus pneumonia, which we diagnosed as OPSI. Splenectomized patients have been recognized as immunocompromized hosts, for whom fulminant bacterial infection can be associated with high morbidity and mortality. Therefore, early diagnosis and urgent treatments are important to reduce the mortality of such infections. To prevent OPSI, adequate vaccination and prophylactic administration of antibiotics seem to be effective. Physicians should always be aware of the onset of OPSI for splenectomized patients.

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