39 results on '"Nakamura, Hideta"'
Search Results
2. Mpox in people with HIV: A narrative review.
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Nakamura, Hideta and Yamamoto, Kazuko
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HIV infection complications , *RECTAL diseases , *RISK assessment , *ANTIRETROVIRAL agents , *HIV-positive persons , *HOSPITAL care , *ANTIVIRAL agents , *MONKEYPOX , *VIRAL vaccines , *IMMUNOSUPPRESSION , *DISEASE progression , *SMALLPOX vaccines , *DISEASE risk factors , *DISEASE complications , *SYMPTOMS ,MORTALITY risk factors - Abstract
Objective: The 2022 global mpox outbreak disproportionately impacted people living with HIV. This review explores recent evidence on mpox in this group, focusing on clinical presentation, complications, treatment modalities and vaccine strategies. Recent findings: Recent studies have suggested that people with HIV diagnosed with mpox have a greater risk of proctitis and hospitalization compared with people without HIV. In addition, those with advanced immunosuppression face an elevated risk of severe mpox infection, which can lead to mortality. Comprehensive and prompt supportive care using antiretrovirals and mpox antivirals is crucial in this group. Although results from randomized clinical trials are still forthcoming, recent studies suggest that early initiation of tecovirimat can prevent disease progression in people with HIV. The non‐replicative attenuated smallpox vaccine is well tolerated and effective in preventing monkeypox virus infections in people with HIV. Further studies are needed regarding long‐term vaccine effectiveness for this population. Conclusion: Evaluating the risk of severe mpox in people living with HIV requires assessing the level of immune suppression and viral control. Universal access to vaccination is imperative to prevent the resurgence of future outbreaks. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Virological outcomes of various first-line ART regimens in patients harbouring HIV-1 E157Q integrase polymorphism: a multicentre retrospective study.
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Uno, Shunsuke, Gatanaga, Hiroyuki, Hayashida, Tsunefusa, Imahashi, Mayumi, Minami, Rumi, Koga, Michiko, Samukawa, Sei, Watanabe, Dai, Fujii, Teruhisa, Tateyama, Masao, Nakamura, Hideta, Matsushita, Shuzo, Yoshino, Yusuke, Endo, Tomoyuki, Horiba, Masahide, Taniguchi, Toshibumi, Moro, Hiroshi, Igari, Hidetoshi, Yoshida, Shigeru, and Teshima, Takanori
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HIV ,HIV-positive persons ,RETROSPECTIVE studies - Abstract
Background Integrase strand transfer inhibitors (INSTIs) are recommended as first-line ART for people living with HIV (PLWH) in most guidelines. The INSTI-resistance-associated mutation E157Q, a highly prevalent (2%–5%) polymorphism of the HIV-1 (human immunodeficiency virus type 1) integrase gene, has limited data on optimal first-line ART regimens. We assessed the virological outcomes of various first-line ART regimens in PLWH with E157Q in real-world settings. Methods A multicentre retrospective observational study was conducted on PLWH who underwent integrase genotypic drug-resistance testing before ART initiation between 2008 and 2019 and were found to have E157Q. Viral suppression (<50 copies/mL) rate at 24 and 48 weeks, time to viral suppression and time to viral rebound (≥100 copies/mL) were compared among the first-line ART regimens. Results E157Q was detected in 167 (4.1%) of 4043 ART-naïve PLWH. Among them, 144 had available clinical data after ART initiation with a median follow-up of 1888 days. Forty-five started protease inhibitors + 2 NRTIs (PI group), 33 started first-generation INSTI (raltegravir or elvitegravir/cobicistat) + 2 NRTIs (INSTI-1 group), 58 started once-daily second-generation INSTI (dolutegravir or bictegravir) + 2 NRTIs (INSTI-2 group) and eight started other regimens. In the multivariate analysis, the INSTI-2 group showed similar or favourable outcomes compared with the PI group for viral suppression rates, time to viral suppression and time to viral rebound. Two cases in the INSTI-1 group experienced virological failure. Conclusions The general guideline recommendation of second-generation INSTI-based first-line ART for most PLWH is also applicable to PLWH harbouring E157Q. [ABSTRACT FROM AUTHOR]
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- 2023
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4. Use of steroids to treat anti-tumor necrosis factor α induced tuberculosis-associated immune reconstitution inflammatory syndrome: Case report and literature review
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Nabeya, Daijiro, Kinjo, Takeshi, Yamaniha, Kazutaka, Yamazato, Shoshin, Tome, Reo, Miyagi, Kazuya, Nakamura, Hideta, Kinjo, Tetsu, Haranaga, Shusaku, Higa, Futoshi, and Fujita, Jiro
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- 2020
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5. Serum levels of receptor-interacting protein kinase-3 in patients with COVID-19
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Nakamura, Hideta, Kinjo, Takeshi, Arakaki, Wakako, Miyagi, Kazuya, Tateyama, Masao, and Fujita, Jiro
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- 2020
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6. The prevalence of airway obstruction among Japanese HIV-positive male patients compared with general population; a case–control study of single center analysis
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Nakamura, Hideta, Tateyama, Masao, Tasato, Daisuke, Haranaga, Shusaku, Ishimine, Tomohiko, Higa, Futoshi, Kaneshima, Hiroshi, and Fujita, Jiro
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- 2014
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7. Late diagnosis of HIV in 2022: Why so little change?
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Collins, Simon, Namiba, Angelina, Sparrowhawk, Alex, Strachan, Sophie, Thompson, Marc, and Nakamura, Hideta
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DIAGNOSIS of HIV infections ,DELAYED diagnosis ,HEALTH services accessibility ,PUBLIC health ,ANTIRETROVIRAL agents ,INFECTIOUS disease transmission ,LGBTQ+ people ,EMERGENCY medical services - Abstract
Background: The proportion of people who are diagnosed late is a key metric to measure the public health response to HIV. But this percentage remains stubbornly high in nearly every country. Delays in accessing antiretroviral therapy affects both (i) individual health, due to a higher risk of mortality, and (ii) population‐based health, due to continued risk of transmission. Despite huge efforts to increase testing, late diagnosis continues to be an indication of a public health failure. Outline: This short review includes community perspectives on why late diagnosis continues and how it may be reduced. We discuss both structural barriers that prevent people from testing earlier and personal reasons why some people still refuse testing when offered. We note that late diagnosis is reported in all countries and in all demographic groups and that sex, gender, age, and sexuality all affect these rates. However, even in groups with high HIV awareness, such as in gay and bisexual men in the UK, more than one in three people with HIV continue to be diagnosed late. Fears and prejudice about HIV based on outdated information are still common among both health workers and people using health services. For example, testing is still not offered in primary or emergency care settings, and even free testing might not be accepted if someone fears the outcome might jeopardize their resident status, employment, relationship, or health. Summary: In addition to developing targeted projects to reach the highest‐risk groups, a positive mainstream public campaign could make testing more acceptable at a broad population level across all demographics. This could challenge and repair the media campaigns from the 1980s that still contribute to the stigma that frightens people away from testing now. We hope that an effective approach in one country might also help others. [ABSTRACT FROM AUTHOR]
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- 2022
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8. Use of the interleukin 6 inhibitor tocilizumab in Japanese patients with cytokine release syndrome caused by COVID-19-related acute respiratory distress syndrome: A case series
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Nakamura, Hideta, Miyagi, Kazuya, Otsuki, Mariko, Higure, Yuuri, Nishiyama, Naoya, Kinjo, Takeshi, Nakamatsu, Masashi, Haranaga, Shusaku, Tateyama, Masao, and Fujita, Jiro
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- 2020
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9. Influenza Epidemics During 2007 and 2013 in Okinawa, Subtropical Region in Japan: Surveillance of Rapid Antigen Results: PS299
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Iha, Yoshikazu, Higa, Futoshi, Sunagawa, Satoko, Naka, Masamitsu, Nakamura, Hideta, Tazato, Daisuke, Nakamatu, Masashi, Miyagi, Kazuya, Haranaga, Shusaku, Tateyama, Masao, and Fujita, Jiro
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- 2013
10. Human immunodeficiency virus‐associated pulmonary sarcoidosis in a Japanese man as a manifestation of immune reconstitution inflammatory syndrome.
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Nakamura, Hideta, Tateyama, Masao, Tasato, Daisuke, Haranaga, Shusaku, Higa, Futoshi, Matsuzaki, Akiko, Yoshimi, Naoki, and Fujita, Jiro
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IMMUNE reconstitution inflammatory syndrome , *JAPANESE people , *SARCOIDOSIS , *HIV infections - Abstract
Asymptomatic pulmonary sarcoidosis can develop after starting antiretroviral therapy. The decision on whether to treat sarcoidosis with corticosteroids should be based on the disease severity. [ABSTRACT FROM AUTHOR]
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- 2020
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11. Use of steroids to treat anti-tumor necrosis factor α induced tuberculosis-associated immune reconstitution inflammatory syndrome: Case report and literature review.
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Daijiro Nabeya, Takeshi Kinjo, Kazutaka Yamaniha, Shoshin Yamazato, Reo Tome, Kazuya Miyagi, Hideta Nakamura, Tetsu Kinjo, Shusaku Haranaga, Futoshi Higa, Jiro Fujita, Nabeya, Daijiro, Kinjo, Takeshi, Yamaniha, Kazutaka, Yamazato, Shoshin, Tome, Reo, Miyagi, Kazuya, Nakamura, Hideta, Kinjo, Tetsu, and Haranaga, Shusaku
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- 2020
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12. Serum KL‐6 can distinguish between different phenotypes of severe COVID‐19.
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Nakamura, Hideta, Miyagi, Kazuya, Otsuki, Mariko, Higure, Yuri, Nishiyama, Naoya, Kinjo, Takeshi, Nakamatsu, Masashi, Haranaga, Shusaku, Tateyama, Masao, and Fujita, Jiro
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COVID-19 ,SERUM - Abstract
Serum KL-6 can distinguish between different phenotypes of severe COVID-19 We read the article by D'Alessandro et al with great interest and appreciate their efforts to evaluate the role of serum Krebs von den Lungen-6 (KL-6) as a prognostic biomarker of severe coronavirus disease 2019 (COVID-19).1 KL-6 is a mucin-like high-molecular-weight glycoprotein expressed in type II pneumocytes and respiratory bronchiolar epithelial cells in the healthy lung.2 Elevated serum levels can predict the prognosis of various interstitial lung diseases (ILDs), including idiopathic pulmonary fibrosis (IPF),3 and D'Alessandro et al1 observed a significant increase in serum KL-6 in critically ill patients with COVID-19 who required mechanical ventilation or intensive care. Here, we report different serum KL-6 kinetics in two patients with severe COVID-19. [Extracted from the article]
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- 2021
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13. Serum levels of receptor-interacting protein kinase-3 in patients with COVID-19.
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Hideta Nakamura, Takeshi Kinjo, Wakako Arakaki, Kazuya Miyagi, Masao Tateyama, Jiro Fujita, Nakamura, Hideta, Kinjo, Takeshi, Arakaki, Wakako, Miyagi, Kazuya, Tateyama, Masao, and Fujita, Jiro
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- 2020
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14. Comparison of two screening tests for HIV-Associated Neurocognitive Disorder suspected Japanese patients with respect to cART usage.
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Kami-Onaga, Kaoru, Tateyama, Masao, Kinjo, Takeshi, Parrott, Gretchen, Tominaga, Daisuke, Takahashi-Nakazato, Ai, Nakamura, Hideta, Tasato, Daisuke, Miyagi, Kyoko, Maeda, Saori, Arae, Hirotaka, Uehara, Hitoshi, Miyagi, Kazuya, Haranaga, Shusaku, and Fujita, Jiro
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COGNITION disorders diagnosis ,DIAGNOSIS of HIV infections ,MINI-Mental State Examination ,MEDICAL screening ,COMPARATIVE studies - Abstract
In this study, we demonstrated the pervasiveness of HIV-associated neurocognitive disorders (HAND) among a selection of Japanese patients as well as evaluated and compared the Mini Mental State Examination (MMSE) and the International HIV Dementia Scale (IHDS) for use as a screening tool among combination anti-retroviral therapy (cART)-naïve and cART experienced patients. The MMSE and the IHDS have both been used as HAND screening tests around the world with variable success. It has been reported the increased usage of cART the utility of these screening tests may have been diminished due to the decreased severity of impairment and the altered pattern of neurocognitive impairments in cART era HAND patients. It is therefore possible the MMSE and the IHDS may still be useful among cART-naïve patients even in the cART era. However, only one study has investigated and compared the screening results of the IHDS among cART-naïve and cART experienced patients. All HIV positive patients who visited, or were admitted, to the Ryukyu University Hospital between January 2009 and March 2014 were evaluated for inclusion. Selected patients (n = 49) had data without omission for all tests. The overall prevalence of HAND in our cohort was 44%. The area under the curve (AUC), for all subjects using the MMSE and the IHDS, were 0.60 and 0.69, respectively. However, the AUC among cART-naïve patients were 0.58 and 0.76 for the MMSE and the IHDS, respectively. Whereas, cART experienced patients had an AUC of 0.60 and 0.61, respectively. Overall, the MMSE demonstrated a poor screening ability for HAND, regardless of cART usage (the cut-off value of 27 had a Youden's J-Index of 0.1, in all groups). Alternatively, the IHDS was moderately useful for HAND screening among cART-naïve patients (the cut-off value of 11 had a Youden's J-Index of 0.4), but performed poorly as a screening test among cART experienced patients (the cut-off value of 11 had a Youden's J-Index of 0.1). [ABSTRACT FROM AUTHOR]
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- 2018
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15. Meningococcal pneumonia in Japan: A case report and literature review
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Hirai, Jun, Kinjo, Takeshi, Tome, Takaaki, Hagihara, Mao, Sakanashi, Daisuke, Nakamura, Hideta, Haranaga, Shusaku, Mikamo, Hiroshige, and Fujita, Jiro
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- 2016
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16. Are MMSE and HDS-R neuropsychological tests adequate for screening HIV-associated neurocognitive disorders?
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Nakazato, Ai, Tominaga, Daisuke, Tasato, Daisuke, Miyagi, Kyoko, Nakamura, Hideta, Haranaga, Shusaku, Higa, Futoshi, Tateyama, Masao, and Fujita, Jiro
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- 2014
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17. Seizure followed by lung edema: An intriguing link between the brain and the lung.
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Arakaki, Wakako, Kinjo, Takeshi, Nakamura, Hideta, and Fujita, Jiro
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SEIZURES (Medicine) ,LUNGS ,PULMONARY edema ,LUNG infections ,EDEMA ,INTERSTITIAL lung diseases ,BRAIN diseases - Abstract
When observing diffuse ground‐glass opacities in both lungs, physicians should consider several diseases, including heart failure, interstitial lung diseases, and pulmonary infections. However, brain diseases rarely cause lung infiltration. We present an instructive case of neurologic pulmonary edema showing a pathological link between the brain and the lung. [ABSTRACT FROM AUTHOR]
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- 2020
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18. Immunopathological characteristics of immune reconstitution inflammatory syndrome caused by Mycobacterium parascrofulaceum infection in a patient with AIDS
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Hibiya, Kenji, Tateyama, Masao, Teruya, Hiromitsu, Nakamura, Hideta, Tasato, Daisuke, Kazumi, Yuko, Hirayasu, Tsuneo, Tamaki, Yuichiro, Haranaga, Shusaku, Higa, Futoshi, Maeda, Shinji, and Fujita, Jiro
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IMMUNE reconstitution inflammatory syndrome , *MYCOBACTERIAL diseases , *ETIOLOGY of diseases , *AIDS patients , *IMMUNOPATHOLOGY , *GRANULOMA , *T cells , *CELLULAR immunity - Abstract
Abstract: Immune reconstitution inflammatory syndrome (IRIS) caused by mycobacterium in patients with AIDS is often experienced in clinical practice. There is, however, a paucity of data documenting the histopathological findings and the pathogenesis. We determined the immunopathological characteristics of IRIS associated with Mycobacterium parascrofulaceum infection in an AIDS patient. A patient presented with pulmonary lymphadenitis and involvement of the pulmonary lingular segment. Portions of the involved lymph nodes and lung were excised, and the immunological properties were analyzed by immunohistochemical assays. The histological characteristics of lymph nodes showed a caseous necrosis. Histopathologically, the pulmonary lesion was composed of exudative and proliferative lesions. CD4+, CD8+, CD57+, and CD25+/FoxP3+ cells were observed in both types of lesions. Clusters of CD20+ cells and GATA3+ cells were predominantly observed in exudative lesions, while T-bet+ cells were dominant in proliferative lesions. ROR-γ+ cells were also observed in exudative lesions. These results indicate that the cellular immunity to mycobacteria was recovering in the lung tissue. In M. parascrofulaceum pulmonary infection, the exudative lesion had characteristics of Th2 and Th17-type immunities. In contrast, the proliferative lesion had characteristics of Th-1 type immunity. Our data provide the first evidence to reveal the status of the axis of distinctive immunity in the process of granuloma formation caused by a mycobacterium-related infection. [Copyright &y& Elsevier]
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- 2011
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19. Association of demographics, HCV co-infection, HIV-1 subtypes and genetic clustering with late HIV diagnosis: a retrospective analysis from the Japanese Drug Resistance HIV-1 Surveillance Network.
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Otani M, Shiino T, Hachiya A, Gatanaga H, Watanabe D, Minami R, Nishizawa M, Teshima T, Yoshida S, Ito T, Hayashida T, Koga M, Nagashima M, Sadamasu K, Kondo M, Kato S, Uno S, Taniguchi T, Igari H, Samukawa S, Nakajima H, Yoshino Y, Horiba M, Moro H, Watanabe T, Imahashi M, Yokomaku Y, Mori H, Fujii T, Takada K, Nakamura A, Nakamura H, Tateyama M, Matsushita S, Yoshimura K, Sugiura W, Matano T, and Kikuchi T
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- Male, Humans, Hepacivirus, Homosexuality, Male, East Asian People, Phylogeny, Retrospective Studies, Cluster Analysis, Demography, HIV-1, Sexual and Gender Minorities, HIV Infections, Hepatitis C
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Introduction: Late diagnosis of the human immunodeficiency virus (HIV) is a major concern epidemiologically, socially and for national healthcare systems. Although the association of certain demographics with late HIV diagnosis has been reported in several studies, the association of other factors, including clinical and phylogenetic factors, remains unclear. In the present study, we conducted a nationwide analysis to explore the association of demographics, clinical factors, HIV-1 subtypes/circulating recombinant form (CRFs) and genetic clustering with late HIV diagnosis in Japan, where new infections mainly occur among young men who have sex with men (MSM) in urban areas., Methods: Anonymized data on demographics, clinical factors and HIV genetic sequences from 39.8% of people newly diagnosed with HIV in Japan were collected by the Japanese Drug Resistance HIV-1 Surveillance Network from 2003 to 2019. Factors associated with late HIV diagnosis (defined as HIV diagnosis with a CD4 count <350 cells/μl) were identified using logistic regression. Clusters were identified by HIV-TRACE with a genetic distance threshold of 1.5%., Results: Of the 9422 people newly diagnosed with HIV enrolled in the surveillance network between 2003 and 2019, 7752 individuals with available CD4 count at diagnosis were included. Late HIV diagnosis was observed in 5522 (71.2%) participants. The overall median CD4 count at diagnosis was 221 (IQR: 62-373) cells/μl. Variables independently associated with late HIV diagnosis included age (adjusted odds ratio [aOR] 2.21, 95% CI 1.88-2.59, ≥45 vs. ≤29 years), heterosexual transmission (aOR 1.34, 95% CI 1.11-1.62, vs. MSM), living outside of Tokyo (aOR 1.18, 95% CI 1.05-1.32), hepatitis C virus (HCV) co-infection (aOR 1.42, 95% CI 1.01-1.98) and not belonging to a cluster (aOR 1.30, 95% CI 1.12-1.51). CRF07_BC (aOR 0.34, 95% CI 0.18-0.65, vs. subtype B) was negatively associated with late HIV diagnosis., Conclusions: In addition to demographic factors, HCV co-infection, HIV-1 subtypes/CRFs and not belonging to a cluster were independently associated with late HIV diagnosis in Japan. These results imply the need for public health programmes aimed at the general population, including but not limited to key populations, to encourage HIV testing., (© 2023 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society.)
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- 2023
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20. Subpleural Curvilinear Shadows Associated with COVID-19.
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Fujita J, Nakamura H, Miyagi K, and Tateyama M
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- Humans, Lung, Pleura, SARS-CoV-2, COVID-19
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- 2021
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21. Case Report: Ischemic Enterocolitis Associated with Coronavirus Disease 2019: Two Case Reports and a Review of the Literature.
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Kinjo T, Hokama A, Nakamura H, Miyagi K, Higure Y, Otsuki M, Nishiyama N, Nakamatsu M, Kinjo T, Tateyama M, and Fujita J
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- Aged, Female, Humans, Male, Middle Aged, COVID-19 complications, Colitis, Ischemic etiology, Enterocolitis etiology, SARS-CoV-2
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The COVID-19 pandemic has caused serious health and social concerns worldwide. Although the primary target of SARS-CoV-2 is the respiratory tract, SARS-CoV-2 infection also causes extrapulmonary symptoms. Previous articles have reported ischemic colitis in COVID-19 patients; however, information regarding its clinical manifestations and pathophysiology is limited. In this case report, we present two cases of ischemic enterocolitis in COVID-19 patients and review past case reports. Our literature review has shown that computed tomography rather than endoscopy was used for the diagnosis, and any region of the intestine was affected. Because the elevation of the D-dimer, which suggested a hypercoagulable state, was reported in most cases, we assumed that thrombosis at any level in the artery and vein was involved in the pathophysiology of COVID-19-associated enterocolitis. SARS-CoV-2-induced endotheliitis can cause both coarctation of the vessels and thrombosis; therefore, both patterns of ischemic colitis, occlusive and nonocclusive, may be involved in COVID-19-associated enterocolitis.
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- 2021
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22. Case Report: Iliopsoas Hematoma during the Clinical Course of Severe COVID-19 in Two Male Patients.
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Nakamura H, Ouchi G, Miyagi K, Higure Y, Otsuki M, Nishiyama N, Kinjo T, Nakamatsu M, Tateyama M, Kukita I, and Fujita J
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- Abscess classification, Abscess diagnosis, Aged, Anticoagulants adverse effects, Antiviral Agents therapeutic use, Blood Coagulation, COVID-19 diagnostic imaging, Fatal Outcome, Hematoma classification, Hematoma drug therapy, Humans, Male, Middle Aged, Muscle, Skeletal virology, Severity of Illness Index, Thigh pathology, Tomography, X-Ray Computed, Treatment Outcome, COVID-19 Drug Treatment, Abscess virology, COVID-19 complications, Hematoma diagnosis, Hematoma virology, Muscle, Skeletal pathology
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Anticoagulation plays a major role in reducing the risk of systematic thrombosis in patients with severe COVID-19. Serious hemorrhagic complications, such as intracranial hemorrhage, have also been recognized. However, intra-abdominal hemorrhage is under-recognized because of its rare occurrence, despite high mortality. Here, we discuss two cases of spontaneous iliopsoas hematoma (IPH) likely caused by anticoagulants during the clinical course of COVID-19. We also explored published case reports to identify clinical characteristics of IPH in COVID-19 patients. The use of anticoagulants may increase the risk of lethal IPH among COVID-19 patients becsuse of scarce data on optimal dosage and adequate monitoring of anticoagulant effects. Rapid diagnosis and timely intervention are crucial to ensure good patient outcomes.
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- 2021
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23. Acute Hypertriglyceridaemia Caused by Tocilizumab in a Patient with Severe COVID-19.
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Nakamura H, Miyagi K, Otsuki M, Higure Y, Nishiyama N, Kinjo T, Nakamatsu M, Haranaga S, Tateyama M, and Fujita J
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- Acute Disease, Antibodies, Monoclonal, Humanized therapeutic use, COVID-19, Coronavirus Infections blood, Coronavirus Infections epidemiology, Humans, Hypertriglyceridemia blood, Interleukin-6 blood, Male, Middle Aged, Pandemics, Pneumonia, Viral blood, Pneumonia, Viral epidemiology, Retrospective Studies, SARS-CoV-2, Triglycerides blood, Antibodies, Monoclonal, Humanized adverse effects, Betacoronavirus, Coronavirus Infections drug therapy, Hypertriglyceridemia chemically induced, Pneumonia, Viral drug therapy
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Treatment with tocilizumab (TCZ) to block interleukin-6 (IL-6) signalling is predicted to mitigate cytokine release syndrome (CRS) caused by coronavirus disease 2019 (COVID-19). However, the adverse effects of TCZ on patients with COVID-19 remain unclear. We herein report a patient with COVID-19 treated with TCZ who developed acute hypertriglyceridaemia. Despite favipiravir treatment, acute respiratory distress syndrome developed in a 45-year-old patient with COVID-19; thus, TCZ was initiated. The triglyceride levels greatly increased after TCZ administration. Physicians should consider the negative impact of TCZ on the lipid profile in patients with COVID-19, although COVID-19-induced CRS itself may be an aggravating factor.
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- 2020
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24. Do infections with disseminated Mycobacterium avium complex precede sweet's syndrome? A case report and literature review.
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Hibiya K, Miyagi K, Tamayose M, Nabeya D, Kinjo T, Takeshima S, Ikemiyagi N, Yamada K, Fujita A, Hashioka H, Kami W, Inamine M, Shibahara D, Nakamura H, Furugen M, Haranaga S, Higa F, Tateyama M, and Fujita J
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- Aged, Anti-Bacterial Agents administration & dosage, Anti-Inflammatory Agents therapeutic use, Drug Therapy, Combination, Glucocorticoids therapeutic use, Humans, Immunocompromised Host, Lymphadenitis etiology, Male, Mycobacterium avium Complex growth & development, Mycobacterium avium-intracellulare Infection diagnosis, Mycobacterium avium-intracellulare Infection drug therapy, Sweet Syndrome diagnosis, Sweet Syndrome drug therapy, T-Lymphocytes, Helper-Inducer classification, Treatment Outcome, Glucocorticoids adverse effects, Mycobacterium avium Complex physiology, Mycobacterium avium-intracellulare Infection complications, Sweet Syndrome etiology, T-Lymphocytes, Helper-Inducer immunology
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Sweet's syndrome is reportedly associated with preceding nontuberculous mycobacterial infections (NTMIs). Here, we report on a systemic Mycobacterium intracellulare infection in a patient on corticoid therapy for Sweet's syndrome. Literature searches show that 69.1% of patients with Sweet's syndrome and NTMIs developed this syndrome later than NTMIs and 89.3% of them developed during the clinical course of a rapidly growing mycobacterial infection. The residual cases were associated with slow-growing mycobacteria (14.3%), but only three cases of Mycobacterium avium complex (MAC) infections before the onset of Sweet's syndrome have been reported, and all of them were caused by disseminated MAC disease. One of these cases developed during corticoid therapy for Sweet's syndrome, while another case had underlying diabetes mellitus. Hence, the occurrence of systemic MAC disease may be an inevitable consequence of long-term steroid use and underlying diseases. Literature searches also show that cervical lymphadenitis was a predominant symptom in NTMIs (90.5%). The present case did not have cervical lymphadenitis although the previously reported MAC cases did experience it. Therefore, lymphadenitis from NTMIs may be related to the pathogenesis of Sweet's syndrome. Hence, should a patient have systemic infection without lymphadenitis, it will be more difficult to clinically confirm that MAC disease is a predisposing factor for Sweet's syndrome.
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- 2017
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25. Evaluation of the Lipid Concentrations after Switching from Antiretroviral Drug Tenofovir Disoproxil Fumarate/Emtricitabine to Abacavir Sulfate/Lamivudine in Virologically-suppressed Human Immunodeficiency Virus-infected Patients.
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Arae H, Tateyama M, Nakamura H, Tasato D, Kami K, Miyagi K, Maeda S, Uehara H, Moromi M, Nakamura K, and Fujita J
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- Adult, Aged, Anti-HIV Agents administration & dosage, Dideoxynucleosides administration & dosage, Dideoxynucleosides adverse effects, Dideoxynucleosides pharmacology, Drug Combinations, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination administration & dosage, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination adverse effects, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination pharmacology, Humans, Lamivudine administration & dosage, Lamivudine adverse effects, Lamivudine pharmacology, Male, Middle Aged, Retrospective Studies, Anti-HIV Agents therapeutic use, Dideoxynucleosides therapeutic use, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination therapeutic use, HIV Infections drug therapy, Lamivudine therapeutic use, Lipids blood
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Objective Recently, tenofovir disoproxil fumatate (TDF)-related side effects, such as renal nephrotoxicity and reduction of bone mineral density, have been reported. Consequently, increased switching from fixed-dose tablet TDF and emtricitabine (TDF/FTC) to abacavir and lamivudine (ABC/3TC) has occurred. Interestingly, while TDF has a lipid-lowering property, one of the ABC-related side effects is hyperlipidemia. Therefore, such switching could cause lipid elevation. To evaluate the change in lipid levels associated with switching from TDF/FTC to ABC/3TC in virologically-suppressed human immunodeficiency virus (HIV)-infected patients. Methods This is a retrospective, single-center study. We included the HIV-infected patients whose therapy included a drug switch from TDF/FTC to ABC/3TC between September 2009 and December 2012 at Ryukyu University Hospital. The exclusion criteria were HIV-RNA >40 copies/mL on the switching day, and a documented therapy change to a lipid-lowering agent or any other antiretroviral agents within 3 months before or after switching. We compared the low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), and triglyceride (TG) levels before switching to three months after. Results A total of 18 patients met the inclusion criteria. The LDL, HDL, and TC levels significantly increased three months following the switch (p<0.05), with median (interquartile range) values of 17 (7, 32), 6 (2, 13), and 27 (10, 45) mg/dL, respectively. The TG values did not markedly change. Conclusion Switching from TDF/FTC to ABC/3TC resulted in significantly increased LDL, HDL, and TC levels.
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- 2016
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26. Acute respiratory distress syndrome due to Strongyloides stercoralis infection in a patient with cervical cancer.
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Kinjo T, Nabeya D, Nakamura H, Haranaga S, Hirata T, Nakamoto T, Atsumi E, Fuchigami T, Aoki Y, and Fujita J
- Subjects
- Animals, Female, Humans, Ivermectin therapeutic use, Middle Aged, Respiratory Distress Syndrome diagnosis, Respiratory Distress Syndrome drug therapy, Risk Factors, Strongyloides stercoralis drug effects, Strongyloidiasis drug therapy, Treatment Outcome, Adrenal Cortex Hormones adverse effects, Respiratory Distress Syndrome parasitology, Sputum parasitology, Strongyloidiasis diagnosis, Strongyloidiasis etiology, Uterine Cervical Neoplasms complications, Uterine Cervical Neoplasms drug therapy
- Abstract
A 62-year-old woman complained of diarrhea and vomiting after receiving chemotherapy for cervical cancer in association with high doses of corticosteroids. Two months later, the patient developed acute respiratory distress syndrome, and numerous Strongyloides stercoralis parasites were found in the intrabronchial discharge. Ivermectin was administered daily until nematodes were no longer detected in the sputum, and the patient's condition was successfully rescued. Antibodies for human T-cell lymphotropic virus-1 (HTLV-1) were positive. HTLV-1 infection and the administration of corticosteroids are known risk factors for strongyloides hyperinfection syndrome. Therefore, physicians should consider this disease in the differential diagnosis of patients from endemic areas who present with gastrointestinal symptoms under these risk factors.
- Published
- 2015
- Full Text
- View/download PDF
27. Interleukin-17A in Legionella pneumonia: a retrospective study.
- Author
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Higa F, Haroon A, Iha Y, Tasato D, Nakamura H, Kinjo T, Tamayose M, Furugen M, Miyagi K, Haranaga S, Tateyama M, and Fujita J
- Subjects
- Aged, Bronchoalveolar Lavage Fluid chemistry, Female, Humans, Male, Middle Aged, Retrospective Studies, Survival Analysis, Interleukin-17 blood, Legionella pneumophila immunology, Legionnaires' Disease pathology
- Abstract
Interleukin (IL)-17A affects the immune system of the lung. Legionella infection can potentially lead to severe pneumonia. The present study aimed to evaluate the role of IL-17A in Legionella pneumonia. Serum IL-17A levels were quantified in both patients with Legionella pneumonia and control subjects; IL-17 was detected in sera from 4 out of 31 patients with Legionella pneumonia but in any controls. There were no differences in peripheral white blood cell counts or other serum biomarkers (C-reactive protein, and lactate dehydrogenase) between IL-17A-positive and IL-17A-negative patients. All IL-17A-positive patients in this cohort survived, where 8 of 27 IL-17A-negative patients did not. IL-17A was detected in available bronchoalveolar (BA) fluid samples from 7 patients with Legionella pneumonia within our cohort. However, the IL-17A and IFN-γ concentrations in BA fluids did not correlate with each other. IL-17A might play a significant role in some cases of Legionella pneumonia.
- Published
- 2015
- Full Text
- View/download PDF
28. Variety and changeability of pulmonary aspergillosis.
- Author
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Haranaga S, Nakamura H, Higa F, and Fujita J
- Subjects
- Aged, Humans, Male, Tomography, X-Ray Computed, Pulmonary Aspergillosis diagnostic imaging, Pulmonary Aspergillosis pathology
- Published
- 2014
- Full Text
- View/download PDF
29. Imported malaria cases in Okinawa Prefecture, Japan.
- Author
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Higa F, Tateyama M, Tasato D, Karimata Y, Nakamura H, Miyagi K, Haranaga S, Hirata T, Hokama A, Cash HL, Toma H, and Fujita J
- Subjects
- Adolescent, Adult, Child, Coinfection, Female, Humans, Japan epidemiology, Malaria drug therapy, Malaria parasitology, Male, Middle Aged, Plasmodium classification, Plasmodium drug effects, Plasmodium genetics, Retrospective Studies, Travel, Treatment Outcome, Young Adult, Antimalarials therapeutic use, Malaria epidemiology, Plasmodium isolation & purification
- Abstract
With the increase in global transportation, imported malaria has become a significant public health concern in Japan. In the present study, we retrospectively analyzed all imported malaria cases in Okinawa Prefecture from 1988 to 2012. In that period, 23 patients with imported malaria were admitted to the University of the Ryukyus Hospital. Malaria types observed included Plasmodium falciparum (14 cases), P. vivax (7 cases), combined P. falciparum and P. ovale (1 case), and combined P. vivax and P. malariae (1 case). All cases were resolved by anti-malarial treatment. The clinical data from these patients highlights the importance of collecting patient travel history and ensuring an adequate supply of both diagnostic test and drug treatments in Okinawa.
- Published
- 2013
- Full Text
- View/download PDF
30. Depression of local cell-mediated immunity and histological characteristics of disseminated AIDS-related Mycobacterium avium infection after the initiation of antiretroviral therapy.
- Author
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Hibiya K, Tateyama M, Teruya K, Mochizuki M, Nakamura H, Tasato D, Furugen M, Higa F, Endo H, Kikuchi Y, Oka S, and Fujita J
- Subjects
- Acquired Immunodeficiency Syndrome drug therapy, Adult, Female, Humans, Male, Middle Aged, Retrospective Studies, Tuberculosis drug therapy, Young Adult, Acquired Immunodeficiency Syndrome immunology, Acquired Immunodeficiency Syndrome pathology, Anti-Retroviral Agents therapeutic use, Immunity, Cellular immunology, Mycobacterium avium immunology, Tuberculosis immunology, Tuberculosis pathology
- Abstract
Objective: The aim of the present study was to examine the immunohistological characteristics of disseminated Mycobacterium avium infection after the initiation of antiretroviral therapy (ART) for acquired immunodeficiency syndrome (AIDS)., Methods: We histologically investigated five autopsied AIDS patients with systemic M. avium infection., Results: The inflammatory cell composition in the affected tissues was assessed using immunohistochemistry. The celiac lymph nodes and intestinal canal were the most commonly involved organs in the AIDS cases. The most common histological feature was unstructured aggregation of histiocytes. Immunohistochemistry revealed depression of CD4(+), CD8(+) and CD57(+) cells in the gut lamina propria and mesenteric lymph nodes., Conclusion: These findings suggest that local cell-mediated immunity is depressed in affected tissues and that the primary histological feature is poor organization of granulomas in mycobacterial lesions, despite the administration of adequate ART.
- Published
- 2013
- Full Text
- View/download PDF
31. Acquired immune-deficiency syndrome with focal onset of Mycobacterium avium infection displaying a histological/genetic pattern of disseminated mycobacteria.
- Author
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Hibiya K, Tateyama M, Niimi M, Teruya H, Karimata Y, Hirai J, Tokeshi Y, Haranaga S, Tasato D, Nakamura H, Ihama Y, Haroon A, Cash HL, Higa F, Hokama A, Ogawa K, and Fujita J
- Subjects
- AIDS-Related Opportunistic Infections pathology, Aged, HIV Infections virology, Humans, Male, Mycobacterium avium Complex classification, Mycobacterium avium Complex genetics, Mycobacterium avium Complex isolation & purification, Mycobacterium avium-intracellulare Infection pathology, Phylogeny, Viral Load, AIDS-Related Opportunistic Infections microbiology, Mycobacterium avium-intracellulare Infection microbiology
- Abstract
A 66-year-old man with human immunodeficiency virus (HIV) infection was admitted for treatment of Pneumocystis pneumonia. Upon admission, a tumor mass adjacent to the thoracic descending aorta was revealed on computed tomography. Histology revealed an exudative granuloma with histiocytes packed with numerous acid-fast bacilli. Mycobacterium avium was isolated from the tissue. A genetic examination of the isolates demonstrated this strain to be located in the cluster consisting of strains that cause systemic infection. The patient's baseline CD4+ cell count was 9/μL and the HIV-RNA viral load was 43,800 copies/mL. This case suggests the possibility of a localized onset of disseminated M. avium infection.
- Published
- 2012
- Full Text
- View/download PDF
32. Pneumocystis jirovecii pneumonia and alveolar hemorrhage in a pregnant woman with human T cell lymphotropic virus type-1 infection.
- Author
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Tamaki Y, Higa F, Tasato D, Nakamura H, Uechi K, Tamayose M, Haranaga S, Yara S, Tateyama M, and Fujita J
- Subjects
- Acute Lung Injury complications, Adult, Diagnosis, Differential, Female, Hemorrhage complications, Humans, Lung Diseases complications, Pneumonia, Pneumocystis diagnosis, Pregnancy, Pulmonary Alveoli, HTLV-I Infections complications, Pneumocystis carinii, Pneumonia, Pneumocystis complications, Pregnancy Complications, Infectious diagnosis
- Abstract
Acute lung injury during pregnancy results in morbidity and mortality in both the mother and the fetus. Pneumocystis jirovecii pneumonia (PCP) is a rare disease but may occur in pregnant immune-suppressed women. Here, we describe a case of acute lung injury due to PCP and alveolar hemorrhage in a pregnant woman who was a human T lymphotropic virus type-1 (HTLV-1) carrier. PCP should be considered in the differential diagnosis of pulmonary complications during pregnancy in HTLV-1 endemic areas., (© 2011 The Japanese Society of Internal Medicine)
- Published
- 2011
- Full Text
- View/download PDF
33. Mechanisms involved in the extension of pulmonary Mycobacterium avium infection from the pulmonary focus to the regional lymph nodes.
- Author
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Hibiya K, Tateyama M, Tasato D, Nakamura H, Atsumi E, Higa F, Tamai K, and Fujita J
- Subjects
- Adult, Disease Progression, Humans, Lymph Nodes microbiology, Male, Mediastinum, Retrospective Studies, Tuberculosis, Pulmonary microbiology, Lymph Nodes pathology, Mycobacterium avium, Tuberculosis, Pulmonary pathology
- Abstract
Purpose: This study was designed to evaluate the mechanism of Mycobacterium avium extension in lung infection., Study Design: Retrospective study., Participants: A 42-year-old man with acquired immune deficiency syndrome and immune reconstitution inflammatory syndrome. The patient developed mediastinal lymphadenopathy and a peripheral lesion in the right upper lobe within 2 weeks of starting highly active antiretroviral therapy., Methods: Pulmonary tissue and lymph nodes were dissected under thoracoscopy and evaluated pathologically and immunohistochemically., Results: Pulmonary pathologic examination revealed extensive granuloma formation throughout the acini. Mycobacterial antigens were found in the macrophages in the alveoli and in the alveolar septa. Some macrophages including mycobacterial antigens were surrounded by lymphatic endothelial cells in the interstitium. In addition, a proliferative granulomatous lesion was found under the intact epithelial layer of a bronchiole. Pathological examination of the lymph nodes revealed aggregated proliferative granulomas with few mycobacteria. Genetically closely related M. avium strains were isolated from both tissues., Conclusions: This study showed the mechanism involved in the progression of pulmonary M. avium infection from the pulmonary focus to the regional lymph nodes via the lymphatic vessels.
- Published
- 2011
34. Clinical symptoms and courses of primary HIV-1 infection in recent years in Japan.
- Author
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Nakamura H, Teruya K, Takano M, Tsukada K, Tanuma J, Yazaki H, Honda H, Honda M, Gatanaga H, Kikuchi Y, and Oka S
- Subjects
- Adult, Anti-Retroviral Agents therapeutic use, Antiretroviral Therapy, Highly Active trends, Female, Follow-Up Studies, HIV Infections drug therapy, Humans, Japan epidemiology, Male, Risk Factors, Time Factors, Young Adult, Disease Progression, HIV Infections diagnosis, HIV Infections epidemiology, HIV-1
- Abstract
Background: The natural course of HIV-1 infection includes 10 years of an asymptomatic period before the development of AIDS. However, in Japan, the disease progression process seems faster in recent years., Methods: The study subjects were 108 new patients with primary HIV-1 infection during the period from 1997 through 2007. We evaluated their clinical symptoms and laboratory data, and then analyzed disease progression in 82 eligible patients. Disease progression was defined as a fall in CD4 count below 350/µL and/or initiation of antiretroviral therapy., Results: Ninety percent of the patients were infected via homosexual intercourse. All patients had at least one clinical symptom (mean; 4.75±1.99) related to primary HIV-1 infection, with a mean duration of 23.2 days (±14.8) and 53.3% of them had to be hospitalized due to severe symptoms. The mean CD4 count and viral load at first visit were 390/µL (±220.1) and 4.81 log10/mL (±0.78), respectively. None developed AIDS during the study period. Estimates of risk of disease progression were 61.0% at 48 weeks and 82.2% at 144 weeks. In patients who required antiretroviral therapy, the median CD4 count was 215/µL (range, 52-858) at initiation of such therapy. Among the patients with a CD4 count of <350/µL at first visit, 53% never showed recovery of CD4 count (>350/µL) without antiretroviral therapy., Conclusion: Despite possible bias in patient population, disease progression seemed faster in symptomatic Japanese patients with recently acquired primary HIV-1 infection than the previously defined natural course of the disease.
- Published
- 2011
- Full Text
- View/download PDF
35. Pulmonary Mycobacterium parascrofulaceum infection as an immune reconstitution inflammatory syndrome in an AIDS patient.
- Author
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Teruya H, Tateyama M, Hibiya K, Tamaki Y, Haranaga S, Nakamura H, Tasato D, Higa F, Hirayasu T, Furugen T, Kato S, Kazumi Y, Maeda S, and Fujita J
- Subjects
- AIDS-Related Opportunistic Infections diagnosis, Acquired Immunodeficiency Syndrome complications, Adult, Antiretroviral Therapy, Highly Active adverse effects, Humans, Immune Reconstitution Inflammatory Syndrome complications, Male, Mycobacterium Infections complications, Respiratory Tract Infections complications, AIDS-Related Opportunistic Infections complications, Acquired Immunodeficiency Syndrome diagnosis, Immune Reconstitution Inflammatory Syndrome diagnosis, Mycobacterium, Mycobacterium Infections diagnosis, Respiratory Tract Infections diagnosis
- Abstract
Nontuberculous mycobacterial (NTM) infection in HIV (human immunodeficiency virus)-infected patients who have started highly active antiretroviral therapy (HAART) is well known to be one scenario of immune reconstitution inflammatory syndrome (IRIS). We encountered the first case in Japan of an HIV-infected patient with pulmonary Mycobacterium parascrofulaceum infection as IRIS. A 34 year-old man with acquired immunodeficiency syndrome (AIDS) was receiving highly active antiretroviral therapy. Lymphadenopathy was observed at the left pulmonary hilum. IRIS was suspected and thoracoscopic surgery was performed to diagnose the cause of lymphadenopathy. Granulomas were observed histologically, and M. parascrofulaceum was cultured. This organism was susceptible to Clarithromycin, rifampicin and levofloxacin. After the operation and without treatment, recurrence of M. parascrofulaceum infection was not observed. M. parascrofulaceum was isolated from several clinical specimens for the first time in 2004. To date, only five cases have been reported.
- Published
- 2010
- Full Text
- View/download PDF
36. Clinical utility of serum beta-D-glucan and KL-6 levels in Pneumocystis jirovecii pneumonia.
- Author
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Nakamura H, Tateyama M, Tasato D, Haranaga S, Yara S, Higa F, Ohtsuki Y, and Fujita J
- Subjects
- AIDS-Related Opportunistic Infections diagnosis, Adult, Aged, Biomarkers blood, Bronchoalveolar Lavage Fluid microbiology, Case-Control Studies, False Positive Reactions, Female, Humans, Male, Middle Aged, Pneumonia, Pneumocystis blood, Proteoglycans, Retrospective Studies, AIDS-Related Opportunistic Infections virology, Mucin-1 blood, Pneumocystis carinii isolation & purification, Pneumonia, Pneumocystis diagnosis, beta-Glucans blood
- Abstract
Objective: New serum markers (1-->3) beta-D-glucan (beta-D-glucan) and KL-6 are reported to be useful for the clinical diagnosis of Pneumocystis jirovecii pneumonia (PCP). However, the utility of these markers in PCP with HIV infection (HIV PCP) and without HIV (non-HIV PCP) is unknown. This study was aimed to evaluate the utility of beta-D-glucan and KL-6 for the diagnosis of PCP in patients with HIV infection (HIV PCP) and non-HIV PCP., Methods: Retrospective study., Patients: We reviewed the medical records of consecutive 35 patients. The serum levels of beta-D-glucan and KL-6 in HIV PCP and non-HIV PCP were comparatively evaluated. We evaluated these markers in survivors and non survivors., Results: The detection rates of serum beta-D-glucan and KL-6 levels in non-HIV PCP were lower than those in HIV PCP (88% vs. 100%, 66% vs. 88%, respectively). The false positive rates of these markers in both groups were similar (12%, 37%, respectively). Oxygenation index, serum albumin, and mechanical ventilation were the variables which were significantly associated with poor outcome in the univariate analysis., Conclusion: In conclusion, beta-D-glucan was a reliable diagnostic marker for PCP. However, the detection rate of beta-D-glucan and KL-6 in non-HIV PCP was lower than in HIV PCP. Neither beta-D-glucan nor KL-6 was associated with the outcome of PCP.
- Published
- 2009
- Full Text
- View/download PDF
37. Pulmonary artery pseudoaneurysm secondary to lung abscess.
- Author
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Haranaga S, Teruya H, Nakamura H, Higa F, Tateyama M, and Fujita J
- Subjects
- Aged, 80 and over, Ampicillin therapeutic use, Anti-Bacterial Agents therapeutic use, Drug Therapy, Combination, Humans, Lung Abscess drug therapy, Male, Sulbactam therapeutic use, Tomography, X-Ray Computed, Aneurysm, False diagnostic imaging, Aneurysm, False etiology, Lung Abscess complications, Pulmonary Artery diagnostic imaging
- Published
- 2009
- Full Text
- View/download PDF
38. Active tuberculosis in patients undergoing hemodialysis for end-stage renal disease: a 9-year retrospective analysis in a single center.
- Author
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Nakamura H, Tateyama M, Tasato D, Teruya H, Chibana K, Tamaki Y, Haranaga S, Yara S, Higa F, and Fujita J
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Humans, Immunoassay, Kaplan-Meier Estimate, Kidney Failure, Chronic therapy, Male, Middle Aged, Renal Dialysis, Retrospective Studies, Risk Factors, Tuberculin Test, Tuberculosis diagnosis, Immunocompromised Host, Interferons blood, Kidney Failure, Chronic immunology, Kidney Failure, Chronic microbiology, Tuberculosis complications, Tuberculosis immunology
- Abstract
Objective: Tuberculosis (TB) in patients undergoing hemodialysis (HD) for end-stage renal disease (ESRD) is commonly thought to be associated with a very poor prognosis. Moreover, it is difficult to diagnose. This report was designed to describe this condition and to determine the mortality rate and risk factors associated with mortality. In addition, the study evaluated the usefulness of QuantiFERON TB-2G((R)) (QFT-2G)., Methods: Retrospective study, Patients: Patients with confirmed TB admitted between January 2001 and May 2009 were retrospectively identified and enrolled. The clinical, radiological, and bacteriological data at the time of admission were recorded. A multivariate analysis was performed to identify the predictive factors for mortality., Results: A total 19 TB patients (6 females; median age, 73 years) were included. TB occurred in most cases within 1.3 years from the initiation of dialysis. Most patients presented with fever (84.2%) and extrapulmonary TB (57.9%). The mortality rate within 24 weeks of the initiation of TB treatment was 36.8%. The factors associated with mortality were: a short duration of dialysis (HR 8.86, 95% CI 1.03-75.7, p=0.04), and underweight (HR 10.88, 95% CI 1.28-92.6, p=0.02). The sensitivity of QFT-2G, acid-fast smear, and polymerase chain reaction was 50, 80, and 88.2% respectively., Conclusion: These data indicate a high incidence of TB in the early stages of HD and a high mortality rate among these patients. The clinical utility of QFT-2G was found to be limited. Hypoalbuminemia might therefore be related to either indeterminate or negative results of QFT-2G.
- Published
- 2009
- Full Text
- View/download PDF
39. Overwhelming pneumococcal bacteremia revealed by a peripheral blood smear in a 74-year-old healthy woman.
- Author
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Nakamura H, Saitou M, Kinjo S, Kaneshima H, Higa F, Tateyama M, and Fujita J
- Subjects
- Aged, Anti-Bacterial Agents therapeutic use, Bacteremia complications, Bacteremia drug therapy, Bacteremia microbiology, Fatal Outcome, Female, Fever etiology, Humans, Nausea etiology, Pneumococcal Infections complications, Pneumococcal Infections drug therapy, Pneumococcal Infections microbiology, Shock, Septic complications, Shock, Septic drug therapy, Shock, Septic microbiology, Streptococcus pneumoniae isolation & purification, Vomiting etiology, Bacteremia blood, Bacteremia diagnosis, Pneumococcal Infections blood, Pneumococcal Infections diagnosis, Shock, Septic blood, Shock, Septic diagnosis
- Abstract
A 76-year-old woman, who had never been seriously ill, was admitted to our hospital with fever and shaking chills. She progressively developed septic shock. We detected Streptococcus pneumoniae in a routine examination of a Giemsa-stained peripheral blood smear. Despite intensive care with antibiotic therapy, she died within several hours after admission. A peripheral blood smear occasionally shows bacteria in cases of overwhelming septicemia, thus indicating a severe impairment of splenic function. We suggest that, in cases of severe septicemia, an examination of a peripheral blood smear is therefore useful for the rapid detection of organisms in comparison to a traditional blood culture.
- Published
- 2007
- Full Text
- View/download PDF
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