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Pneumococcal Vertebral Osteomyelitis and Psoas Abscess in a Patient with Systemic Lupus Erythematosus Disclosing Positivity of Pneumococcal Urinary Antigen Assay

  • Matsumura Masami
    Research Center for Medical Education, Kanazawa University Graduate School of Medicine, Japan
  • Ito Kiyoaki
    Division of Rheumatology, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Japan
  • Kawamura Rika
    Division of Rheumatology, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Japan
  • Fujii Hiroshi
    Division of Rheumatology, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Japan
  • Inoue Ryo
    Division of Rheumatology, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Japan
  • Yamada Kazunori
    Division of Rheumatology, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Japan
  • Yamagishi Masakazu
    Division of Cardiology, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Japan
  • Kawano Mitsuhiro
    Division of Rheumatology, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Japan

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Abstract

A 53-year-old woman with systemic lupus erythematosus presented with a 3-day history of fever and coughing. Diagnosis of pneumococcal bronchitis was made based on symptoms and positivity of pneumococcal urinary antigen test. On day 3, severe low back pain acutely occurred. Pneumococcal vertebral osteomyelitis and psoas abscess was diagnosed 17 days later by yield of penicillin-susceptible S. pneumoniae strain in blood cultures and drainage fluid. Although pneumococcal urinary antigen test is a useful tool for the diagnosis of pneumococcal pneumonia, we should consider the possibility of pneumococcal infections other than pneumonia or overwhelming bacteremia in immunosuppressive patients when urinary antigen test is positive.<br>

Journal

  • Internal Medicine

    Internal Medicine 50 (20), 2357-2360, 2011

    The Japanese Society of Internal Medicine

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