Bacteremia due to Moraxella Catarrhalis is rare. An 85-year-old Japanese woman had productive cough, dyspnea, and fever. She type 2 diabetes mellitus chronic heart failure. Infiltration shown on chest radiography could be explained by failure or pneumonia. Initial blood culture yielded Gram-negative cocci, identified as M. catarrhalis. We therefore diagnosed cardiogenic pulmonary edema catarrhalis has a high prevalence of β- lactamase production, so treatment comprised ampicillin/sulbactam....

ABSTRACT Background Blood culture is important in the diagnosis of blood infections and identification treatment strategies. Increased contamination a reduction quality care. This retrospective observational study, set an emergency department Japan, aims to elucidate rate before after introduction prevention activities. Methods We compared rates one year Specifically, these activities included novel specific use cart adherence checklist. The checklist noting actual site collection, method...

A 71-year-old woman with previously undiagnosed human T-lymphotropic virus type 1 (HTLV-1) infection presented fever, urinary difficulties, acute abdominal pain, and severe kidney injury (AKI). Diagnostic evaluations confirmed pyelonephritis (APN) focal bacterial nephritis (AFBN). Despite antibiotic treatment, she required temporary hemodialysis eventually developed chronic disease. This case highlights the importance of considering APN AFBN as differential diagnoses in patients presenting...

Objective This study evaluated the effectiveness of a multidisciplinary team deprescribing intervention to reduce polypharmacy and potentially inappropriate medications (PIMs) in elderly orthopedic inpatients. Methods In this single-center retrospective observational study, inpatients ≥75 years old prescribed ≥6 different were enrolled as participants. Interventions comprised team-led screening suggestions regarding any unnecessary during hospital stays. The primary outcome was reduction...

Objectives To determine the incidence of bacteremia in patients with DKA.Methods We conducted a cross-sectional study aged 18 years and older principal diagnosis DKA or hyperglycemic hyperosmotic syndrome (HHS) who presented to our community hospital between 2008 2020. Using medical records from initial visits, we retrospectively calculated bacteremia. This was defined as percentage subjects positive blood cultures except for those contamination.Results Among 114 emergency, two sets were...

Japanese spotted fever (JSF) is an uncommon but potentially fatal infection transmitted by tick bites. We herein report a fulminant case of JSF that occurred in immunocompetent adult was complicated disseminated intravascular coagulation and hemophagocytic lymphohistiocytosis (HLH). discuss the difficulty making diagnosis identifying complication HLH our patient. rare rickettsiosis, this first reported English adult. Secondary caused rickettsiosis requires different treatment from primary...

Hemolytic anemia is a rarely occurring manifestation of native valve infective endocarditis. We herein report an afebrile patient with hemolytic caused by Cardiobacterium hominis A 60-year-old Japanese man had history aortic root replacement and the gradual onset general fatigue. He anemia. Blood cultures detected C. hominis. transthoracic echocardiogram showed vegetation periannular abscess perforation non-coronary cusp. Intravascular hemolysis recovered after antimicrobial therapy,...

We herein report a case of immune-mediated necrotizing myopathy (IMNM) in patient with microscopic polyangiitis (MPA). A 77-year-old Japanese woman presented 2-day history proximal muscle weakness and myalgia, elevated serum creatinine kinase (CK) levels. Findings biopsy were compatible IMNM; however, anti-SRP anti-HMGCR antibodies negative. She also had peripheral neuropathy MPO-ANCA titers, leading to diagnosis MPA. IMNM can be pathological result MPA involvement.

Giant cell arteritis (GCA) can result in visual loss and other sequelae. An 81-year-old man presented with a one-week history of fever. He had bilateral temporal headache, jaw claudication, tenderness the arteries recent skin rash. A artery biopsy showed typical GCA, but symptoms were self-limiting. We continued close observation, without administering prednisolone treatment. Five months later, did not recur, again was administered. Our patient an atypical course GCA that created clinical...

Myocardial injury after non-cardiac surgery is due to ischaemia either during or within 30 days it. Our surveillance protocol includes hip fracture template and high-sensitivity troponin stratification, as recommended in European countries. retrospective study cohort included surgical patients for at our hospital Japan. The primary outcome was the rate of myocardial comparison managed with (213) without (176) template. used more than those surgery. When used, had a higher likelihood...

Autoimmune factor XIII/13 deficiency (aFXIII deficiency) is a rare hemorrhagic disorder, for which typical guideline-directed treatment aggressive immunosuppressive therapy. Approximately 20% of patients are over 80 years old; however, and optimum management such has not reached consensus. Our elderly patient had massive intramuscular hematoma, aFXIII was diagnosed. The opted against therapy, so he managed with conservative only. Thorough survey other correctable causes bleeding anemia also...

Scleredema is a rare cutaneous mucinosis characterized by diffuse swelling and non-pitting induration. A 63-year-old man reported 5-year history of skin thickening the trunk 3-week dyspnea. Echocardiography revealed hypokinesis. Skin biopsies obtained from waist showed thickened dermis with mucin. Myocardial alcian blue-stained tissue between muscle fibers. The patient was referred to dermatologist for phototherapy. Cardiomyopathy should be considered in patients scleredema. usually has good...

Abstract Our patient had appendicitis complicated by Chlamydia trachomatis ‐induced Fitz‐Hugh‐Curtis syndrome and cervicitis. Differential diagnosis was challenging. A 22‐year‐old Japanese woman febrile presented with vomiting subsequent abdominal pain. She unprotected sexual intercourse multiple partners. high Alvarado score lack of cervical motion pain, despite inflammation. Noncontrast CT showed enlarged appendix. Laparoscopic appendectomy revealed acute suppurative perihepatic adhesion....

Hereditary hemorrhagic telangiectasia (HHT) is a risk of infection, such as by brain abscess associated with pulmonary arteriovenous malformations. However, association between HHT and recurrent erysipelas not well described. can cause vessel malformations in organs, leading to various serious outcomes. Prophylactic treatment effective, but many people are undiagnosed. described factor for soft tissue may increase the infections requiring hospitalization. Our 72-year-old female patient was...

Objectives:Kikyo-to (Kt), a herbal medicine composed of glycyrrhiza root (Chinese licorice) and Platycodon extracts bellflower), is commonly used in Japan for relief throat symptoms related to acute upper respiratory tract infection (URTI). Its effectiveness on URTI-associated sore pain over 30 min examined here comparison with placebo. Design: Randomized double-blinded multicenter trial. Settings/Location: Two local Japanese medical centers primary care. Subjects: Patients aged 20-65 years...

Specific antibody deficiency against pneumococcal serotypes was detected in a patient with recurrent episodes of fever. A 21-year-old man presented two-month history fever and shaking chills. He diagnosed pneumonia caused by Streptococcus pneumoniae serotype 19A treated amoxicillin. Serotype-specific antibodies were not produced most the serotypes, which consistent moderate specific deficiency. After 13-valent conjugate vaccination polysaccharide vaccination, he adequately responded to...

The aim of this study was to examine whether the distance between skin and renal pelvis affects detection costovertebral angle (CVA) tenderness in patients with acute focal bacterial nephritis (AFBN).We retrospectively reviewed charts our April 2013 June 2019 who were diagnosed as having AFBN. Diagnosis based on ultrasound or computed tomography contrast, revealing at least one wedge-shaped area decreased vascularity confirmation fever not attributable another condition.We extracted 23...