剖検時の細菌学的検査（PMM；postmortem microbiology）により主たる死因を証明し得た骨髄異形成症候群

丸田 雅樹, 末盛 浩一郎, 谷脇 真潮, 村上 忍, 福島 万奈, 加藤 潤一, 木原 久文, 名部 彰悟, 池田 祐一, 越智 俊元, 波呂 卓, 谷本 一史, 竹内 一人, 山之内 純, 宮本 仁志, 竹中 克斗

doi:10.11150/kansenshogakuzasshi.96.148

<p>A 69-year-old male was admitted to Ehime University Hospital with bicytopenia. He was diagnosed with myelodysplastic syndrome (MDS) and was administered chemotherapy. He was a multimorbid patient with chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), type 2 diabetes, and Sweet's disease resulting in a skin rash. The patient was treated with oral prednisolone for Sweet's syndrome, and cefepime infusions for pneumonia that arose during the first course of chemotherapy. Both of these complications were almost recovered on physical and image findings. During the second course of chemotherapy, he developed Kytococcus schroeteri bacteremia that was successfully treated with linezolid and meropenem infusions, but he died owing to Stenotrophomonas maltophilia bacteremia that occurred 6 h after the K. schroeteri bacteremia. Postmortem microbiology (PMM) proved his reservoir of S. maltophilia bacteremia as pneumonia. There are only 20 reports of K. schroeteri bacteremia in the Medline database. According to our knowledge, this is the first case that developed K. schroeteri and S. maltophilia bacteremia sequentially. In addition, this case highlights the importance of PMM in improving treatment of infectious diseases.</p>

剖検時の細菌学的検査（PMM；postmortem microbiology）により主たる死因を証明し得た骨髄異形成症候群

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剖検時の細菌学的検査（PMM；postmortem microbiology）により主たる死因を証明し得た骨髄異形成症候群

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