Pneumococcal Vertebral Osteomyelitis and Psoas Abscess in a Patient with Systemic Lupus Erythematosus Disclosing Positivity of Pneumococcal Urinary Antigen Assay
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- Matsumura Masami
- Research Center for Medical Education, Kanazawa University Graduate School of Medicine, Japan
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- Ito Kiyoaki
- Division of Rheumatology, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Japan
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- Kawamura Rika
- Division of Rheumatology, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Japan
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- Fujii Hiroshi
- Division of Rheumatology, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Japan
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- Inoue Ryo
- Division of Rheumatology, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Japan
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- Yamada Kazunori
- Division of Rheumatology, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Japan
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- Yamagishi Masakazu
- Division of Cardiology, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Japan
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- 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
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- Internal Medicine
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Internal Medicine 50 (20), 2357-2360, 2011
The Japanese Society of Internal Medicine