Autopsy Report for an Anorexia Nervosa Patient Who Died of Hemorrhagic Necrotic Colitis due to Suspected Clostridium perfringens Infection

Nishida Shinji, Koyama Atsuko, Matsuoka Hiromichi, Hirano Tomoko, Jinnai Rikako, Tochihara Kyoko, Iwagami Kaori

doi:10.15064/jjpm.47.10_875

Bibliographic Information

Other Title

ウェルシュ菌を疑われる起炎菌により,出血性壊死性腸炎にて死亡した神経性食思不振症患者の剖検例
症例研究ウェルシュ菌を疑われる起炎菌により,出血性壊死性腸炎にて死亡した神経性食思不振症患者の剖検例
ショウレイケンキュウウェルシュキンオウタガワレルキエンキンニヨリシュッケツセイエシセイチョウエンニテシボウシタシンケイセイショクシフシンショウカンジャノボウケンレイ

Search this article

Description

The patient was a 23-year-old woman. In September "X-2" year, she visited our hospital due to excessive weight loss. Anorexia nervosa was diagnosed and she was hospitalized the same day. Condition improved with behavior therapy at the hospital and she was discharged in December. However, she discontinued follow-ups at the hospital until June "X-1" year. On February 1, "X" year, the patient experienced abdominal pain during the night, so she visited another hospital and received drip infusion. Condition worsened and she was brought to our hospital the next morning. On arrival, she was severely emaciated and in shock, so immediate rescue with artificial respiration and drip infusion of saline, corticosteroid, vasopressor and bicarbonate was initiated. Condition improved temporarily, but paralytic ileus and gastrointestinal bleeding developed and she died 17h after arrival. Based on autopsy findings and clinical symptoms, hemorrhagic necrotic colitis, pneumatosis cystoids intestinalis and hepatic portal vein gas were diagnosed. Clostridium perfringens was considered as the causative agent. This bacterium is widely distributed in the environment and frequently occurs in the intestinal tract of humans and many domestic and feral animals. Complications and death only occur very rarely. However, in malnourished patients with poor immune status as seen with anorexia nervosa, C. perfringens may cause severe disease.

Journal

Japanese Journal of Psychosomatic Medicine

Japanese Journal of Psychosomatic Medicine 47 (10), 875-881, 2007

Japanese Society of Psychosomatic Medicine

Keywords

Details 詳細情報について

Export

Report a problem