A Case of Septic Pulmonary Embolism due to <i>Peptostreptococcus micros</i> with Multiple Infection of the Head and Neck

UBUKATA Satoshi, JINGU Daisuke, YAJIMA Takehiro, SHOJI Makoto, TAKAHASHI  Hiroshi

doi:10.11150/kansenshogakuzasshi.87.761

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多彩な頭頸部病変を呈した <i>Peptostreptococcus micros</i> による敗血症性肺塞栓症の 1 例
症例多彩な頭頸部病変を呈したPeptostreptococcus microsによる敗血症性肺塞栓症の1例
ショウレイタサイナアタマケイブビョウヘンオテイシタ Peptostreptococcus micros ニヨルハイケツショウセイハイソクセンショウノ 1レイ

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A 46-year-old man with no underlying diseases visited our hospital with otorrhea, ocular motility disorder of the left eye, dizziness and loss of appetite which had lasted for two months. Chest radiography and computed tomography (CT) showed bilateral multiple pulmonary nodules and cavities. Furthermore, CT of the head and neck revealed bilateral mastoiditis, a left orbital abscess and a deep neck abscess. Peptostreptococcus micros was cultured from blood and otorrhea specimens. In addition, P. micros DNA was detected with the polymerase chain reaction (PCR) method in the specimens from the site of culture-negative lesions (i.e. sputum, bronchoalveolar lavage, neck abscess). Thus, we diagnosed the lung lesions as septic pulmonary embolisms (SPEs). The clinical findings of the head and neck had improved following antibiotics treatment for five weeks, and follow-up chest radiography and CT showed that all lesions almost disappeared. Since some SPE patients demonstrate a slow progression, SPE should be included in the differential diagnosis of multiple pulmonary nodules such as Wegenerʼs glanulomatosis or neoplasm.

Journal

Kansenshogaku Zasshi

Kansenshogaku Zasshi 87 (6), 761-766, 2013

The Japanese Association for Infectious Diseases

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