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5. A Case Report of Cerebral Meningitis Caused by Penicillin-Non-Susceptible Group B Streptococcus in an Immunocompromised Adult Patient

Author

Hirai, Jun, Kinjo, Takeshi, Haranaga, Shusaku, and Fujita, Jiro

Subjects
adult, PRGBS, meningitis, Case Report, serotype Ib, Streptococcus agalactiae, corticosteroids
Abstract

Streptococcus agalactiae, also known as Group B Streptococcus (GBS), is the leading cause of bacteremia and meningitis in neonates; however, it also causes meningitis in adults, although much less frequently. After the detection of penicillin-non-susceptible GBS (PRGBS) for the first time in 2008 by Japanese researchers, clinical PRGBS isolates have been reported worldwide. These isolates need to be given due attention for being non-susceptible to multiple drugs. Herein, we present the first clinical report of meningitis caused by PRGBS. A 41-year-old Japanese male receiving an immunosuppressant visited hospital complaining of fever. Although he did not have meningitis-related symptoms or physical findings, determination of the cause of fever by Gram-staining of the spinal fluid revealed gram-positive cocci in pairs and chains. Initially, he was hospitalized on the diagnosis of cerebral meningitis caused by Streptococcus pneumoniae. However, culture of the spinal fluid revealed the β-hemolytic colonies on blood agar. Biochemical testing and mass spectrometry revealed the isolated organism as GBS (serotype Ib). The minimum inhibitory concentration (MIC) of penicillin G for the isolated strain was 0.5 μg/mL, which is greater than the MIC criteria for “susceptibility” to penicillin G for beta-hemolytic streptococci according to Clinical and Laboratory Standards Institute standards. The isolated strain was also resistant to macrolide (MIC ≥ 8 μg/mL) and fluoroquinolone (MIC ≥ 8 μg/mL). The patient recovered without neurologic sequelae upon treatment with ceftriaxone, vancomycin, and corticosteroids for 4 days, and subsequently with ampicillin for 17 days. The rate of isolation of PRGBS in the clinics has gradually increased, particularly in Japan. Although PRGBS isolated in the present case was susceptible to ampicillin and cephalosporins, strains not susceptible to ampicillin, cefotaxime, and ceftriaxone have already been isolated, indicating the prospects for limited range of effective antibiotics against PRGBS infections, including meningitis, in the near future.

Published
2020

6. The First Case of Community-Acquired Pneumonia Due to Capsular Genotype K2-ST86 Hypervirulent Klebsiella pneumoniae in Okinawa, Japan: A Case Report and Literature Review

Author

Hirai, Jun, Sakanashi, Daisuke, Kinjo, Takeshi, Haranaga, Shusaku, and Fujita, Jiro

Subjects
hypervirulent Klebsiella pneumoniae, community-acquired pneumonia, Streptococcus pneumoniae, lobar pneumonia, Case Report, serotype K2, sequence type 86
Abstract

Hypervirulent Klebsiella pneumoniae (HV-KP) typically causes pyogenic liver abscess and bacteremia with metastatic infections. Community-acquired pneumonia (CAP) due to HV-KP is uncommon and details of its clinical and microbiological features are limited. We report the first case of CAP due to capsular genotype K2-ST86 HV-KP in Okinawa, Japan and review infections caused by the K2-ST86 strain. A 79-year-old woman presenting with fever and productive cough persisting for the past three days was admitted to hospital. Her vital signs indicated septic shock. Lung examination by auscultation revealed holo-crackle and lobar pneumonia in chest radiography, and Streptococcus pneumoniae was suspected. However, sputum and blood cultures revealed Gram-negative coccus identified as K. pneumoniae. Genetic analysis identified the isolated strain as the K2 serotype harboring rmpA, iutA, entB, and mrkD. Therefore, we identified the isolated strain as hypervirulent. The isolate belonged to ST86 as determined by multilocus sequence typing. The case was not complicated by predisposing factors such as diabetes mellitus and malignancy related to HV-KP infection; thus, this CAP-causing HV-KP strain may differ from the typical HV-KP strain that induces liver abscess. A literature review identified only nine cases with CAP due to HV-KP. In all cases, the disease mainly occurred in older males with diabetes mellitus, which makes the present case unusual, and had high rates of septic shock and death. No case, including ours, was complicated by metastatic infection, suggesting that CAP due to HV-KP poses little distant metastasis risk, even in patients with bloodstream infection. In our review, consistent with our case, K2-ST86 was the most common strain of HV-KP in patients with CAP. Therefore, studies are needed to elucidate the clinical and microbiological features of HV-KP CAP, with a focus on the K2-ST86 strain. Physicians should always consider K. pneumoniae in cases of sepsis CAP with lobar pneumonia.

Published
2020

7. Case Report of Primary Lung Abscesses Due to Hypervirulent Klebsiella pneumoniae (Serotype K2, Sequence Type 375): an Emerging Isolate in Okinawa, Japan

Author

Hirai, Jun, Sakanashi, Daisuke, Momose, Masashi, Koga, Tomomi, Kinjo, Takeshi, Haranaga, Shusaku, Motonaga, Eiji, and Fujita, Jiro

Subjects
hypervirulent Klebsiella pneumoniae, Okinawa, Japan, Case Report, sequence type 375, serotype K2, primary lung abscess
Abstract

Hypervirulent Klebsiella pneumoniae (HV-KP) is typically associated with community-acquired liver abscess and bacteremia with metastatic infection; however, primary lung abscess (PLA) caused by HV-KP is rare, with only one such case report to date. A 69-year-old man with a history of diabetes mellitus (DM) was admitted to hospital complaining of slight bloody sputum. Chest imaging showed multiple consolidations with cavities in both lung fields. A culture of bronchoalveolar lavage fluid confirmed the presence of K. pneumoniae. Genetic analyses identified the isolate as serotype K2 and sequence type 375 (K2-ST375), and that it harbored the rmpA gene. The patient was an Asian middle-aged male with DM, all of which are risk factors for HV-KP infection. Although complicating DM and the presence of the rmpA gene are more likely to induce disseminated infection, metastatic infections were not found in this patient. The clinical and microbiological characteristics of our patient were different from those of a previous reported case, although in both cases the patient was from Asia and had DM. Therefore, DM appears to be one of the predisposing factors for HV-KP lung abscesses and physicians should pay attention to emerging HV-KP lung abscess infection, particularly in Asian countries. Previous studies have also revealed that K2-ST375 is one of the major clones causing HV-KP infection, and that it is mainly isolated from patients with liver abscess. Interestingly, including the present case, most of the infectious cases caused by K2-ST375 have been reported from Okinawa Prefecture in Japan. Therefore, the trend of the K2-ST375 strain should be carefully monitored, particularly in Okinawa, Japan. The serotype of HV-KP that causes PLA is still unknown and further study is needed to elucidate the etiology of PLA due to HV-KP and the relationship between the strain K2-ST375 and PLA.

Published
2020

9. A long‐term survivor keeping in a complete response without treatment after pemetrexed maintenance therapy for advanced non‐squamous non‐small cell lung cancer

Author

Furugen, Makoto, primary, Shibahara, Daisuke, additional, Kiyuna, Tomo, additional, Kami, Wakaki, additional, Miyagi, Kazuya, additional, Haranaga, Shusaku, additional, Kubota, Toru, additional, Matsumoto, Hirofumi, additional, Yoshimi, Naoki, additional, and Fujita, Jiro, additional

Published
2020
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15. Diagnostic performance of serum interferon gamma, matrix metalloproteinases, and periostin measurements for pulmonary tuberculosis in Japanese patients with pneumonia

Author

Yamauchi, Momoko, primary, Kinjo, Takeshi, additional, Parrott, Gretchen, additional, Miyagi, Kazuya, additional, Haranaga, Shusaku, additional, Nakayama, Yuko, additional, Chibana, Kenji, additional, Fujita, Kaori, additional, Nakamoto, Atsushi, additional, Higa, Futoshi, additional, Owan, Isoko, additional, Yonemoto, Koji, additional, and Fujita, Jiro, additional

Published
2020
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16. A pulmonary nodule in a patient with Crohn’s disease

Author

Hokama, Akira, primary, Haranaga, Shusaku, additional, Sasaki, Takanobu, additional, Matsumoto, Hirofumi, additional, Ohira, Tetsuya, additional, Iraha, Atsushi, additional, Kinjo, Tetsu, additional, Nahar, Saifun, additional, and Fujita, Jiro, additional

Published
2019
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18. A long‐term survivor keeping in a complete response without treatment after pemetrexed maintenance therapy for advanced non‐squamous non‐small cell lung cancer.

Author

Furugen, Makoto, Shibahara, Daisuke, Kiyuna, Tomo, Kami, Wakaki, Miyagi, Kazuya, Haranaga, Shusaku, Kubota, Toru, Matsumoto, Hirofumi, Yoshimi, Naoki, and Fujita, Jiro

Subjects
NON-small-cell lung carcinoma, PEMETREXED
Abstract

Pemetrexed has significant efficacy for some non‐squamous non‐small cell lung cancer cases, as demonstrated in the current case. For those patients, pemetrexed administration should be carefully considered. [ABSTRACT FROM AUTHOR]

Published
2021
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19. Legionella pneumophila infection induces programmed cell death, caspase activation, and release of high-mobility group box 1 protein in A549 alveolar epithelial cells: inhibition by methyl prednisolone

Author

Koide Michio, Yara Satomi, Haranaga Shusaku, Akamine Morikazu, Teruya Hiromitsu, Hibiya Kenji, Higa Futoshi, Furugen Makoto, Tateyama Masao, Mori Naoki, and Fujita Jiro

Subjects
Diseases of the respiratory system, RC705-779
Abstract

Abstract Background Legionella pneumophila pneumonia often exacerbates acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Apoptosis of alveolar epithelial cells is considered to play an important role in the pathogenesis of ALI and ARDS. In this study, we investigated the precise mechanism by which A549 alveolar epithelial cells induced by L. pneumophila undergo apoptosis. We also studied the effect of methyl prednisolone on apoptosis in these cells. Methods Nuclear deoxyribonucleic acid (DNA) fragmentation and caspase activation in L. pneumophila-infected A549 alveolar epithelial cells were assessed using the terminal deoxyribonucleotidyl transferase-mediated triphosphate (dUTP)-biotin nick end labeling method (TUNEL method) and colorimetric caspase activity assays. The virulent L. pneumophila strain AA100jm and the avirulent dotO mutant were used and compared in this study. In addition, we investigated whether methyl prednisolone has any influence on nuclear DNA fragmentation and caspase activation in A549 alveolar epithelial cells infected with L. pneumophila. Results The virulent strain of L. pneumophila grew within A549 alveolar epithelial cells and induced subsequent cell death in a dose-dependent manner. The avirulent strain dotO mutant showed no such effect. The virulent strains of L. pneumophila induced DNA fragmentation (shown by TUNEL staining) and activation of caspases 3, 8, 9, and 1 in A549 cells, while the avirulent strain did not. High-mobility group box 1 (HMGB1) protein was released from A549 cells infected with virulent Legionella. Methyl prednisolone (53.4 μM) did not influence the intracellular growth of L. pneumophila within alveolar epithelial cells, but affected DNA fragmentation and caspase activation of infected A549 cells. Conclusion Infection of A549 alveolar epithelial cells with L. pneumophila caused programmed cell death, activation of various caspases, and release of HMGB1. The dot/icm system, a major virulence factor of L. pneumophila, is involved in the effects we measured in alveolar epithelial cells. Methyl prednisolone may modulate the interaction of Legionella and these cells.

Published
2008
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20. Use of steroids to treat anti-tumor necrosis factor α induced tuberculosis-associated immune reconstitution inflammatory syndrome: Case report and literature review.

Author

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

Published
2020
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21. Comparison of two screening tests for HIV-Associated Neurocognitive Disorder suspected Japanese patients with respect to cART usage

Author

Kami-Onaga, Kaoru, primary, Tateyama, Masao, additional, Kinjo, Takeshi, additional, Parrott, Gretchen, additional, Tominaga, Daisuke, additional, Takahashi-Nakazato, Ai, additional, Nakamura, Hideta, additional, Tasato, Daisuke, additional, Miyagi, Kyoko, additional, Maeda, Saori, additional, Arae, Hirotaka, additional, Uehara, Hitoshi, additional, Miyagi, Kazuya, additional, Haranaga, Shusaku, additional, and Fujita, Jiro, additional

Published
2018
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22. Role of neuraminidase inhibitor chemoprophylaxis in controlling nosocomial influenza: an observational study

Author

Higa, Futoshi, Tateyama, Masao, Tomishima, Miyuki, Mukatake, Sakiko, Yamashiro, Tsuyoshi, Owan, Tomoko, Haranaga, Shusaku, and Fujita, Jiro

Subjects
Cross Infection, Incidence, neuraminidase inhibitor, Neuraminidase, Original Articles, Chemoprophylaxis, infection control, Antiviral Agents, Chemoprevention, Hospitals, University, Viral Proteins, Treatment Outcome, Influenza, Human, Humans, Original Article, influenza, Retrospective Studies
Abstract

Please cite this paper as: Higa et al. (2012) Role of neuraminidase inhibitor chemoprophylaxis in controlling nosocomial influenza: an observational study. Influenza and Other Respiratory Viruses 6(4), 299–303. Background An influenza outbreak might result in disruption of services at acute care setting hospitals. Objectives In this study, we retrospectively evaluated the use of neuraminidase inhibitor chemoprophylaxis for prevention of nosocomial spread of influenza in a university hospital. Patients/Methods During the 3‐year study period, 202 index cases of influenza [30 hospitalized patients and 172 healthcare workers (HCW)] and 762 individuals who had had close contact with the index cases (248 hospitalized patients and 514 HCW) were identified. Of these contacts, 416 received neuraminidase inhibitor chemoprophylaxis. Results When both the index cases and the close contacts were hospitalized patients, the incidence of influenza was lower among the close contacts who received chemoprophylaxis than among those who did not (odds ratio, 0·07; confidence interval, 0·01–0·49; P = 0·012). In contrast, when the index cases were HCW, the incidence of influenza was not different between close contacts who did or did not receive chemoprophylaxis. Conclusions This study suggests that chemoprophylaxis might be useful to prevent nosocomial spread of infection between hospitalized patients.

Published
2011

24. Do infections with disseminated Mycobacterium avium complex precede sweet's syndrome? A case report and literature review

Author

Hibiya, Kenji, primary, Miyagi, Kazuya, additional, Tamayose, Maki, additional, Nabeya, Daijiro, additional, Kinjo, Takeshi, additional, Takeshima, Syo, additional, Ikemiyagi, Nanae, additional, Yamada, Keisuke, additional, Fujita, Akane, additional, Hashioka, Hiroe, additional, Kami, Wakaki, additional, Inamine, Morifumi, additional, Shibahara, Daisuke, additional, Nakamura, Hideta, additional, Furugen, Makoto, additional, Haranaga, Shusaku, additional, Higa, Futoshi, additional, Tateyama, Masao, additional, and Fujita, Jiro, additional

Published
2017
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26. Adjunctive Systemic Corticosteroids for Hospitalized Community-Acquired Pneumonia: Systematic Review and Meta-Analysis 2015 Update

Author

Horita, Nobuyuki, primary, Otsuka, Tatsuya, additional, Haranaga, Shusaku, additional, Namkoong, Ho, additional, Miki, Makoto, additional, Miyashita, Naoyuki, additional, Higa, Futoshi, additional, Takahashi, Hiroshi, additional, Yoshida, Masahiro, additional, Kohno, Shigeru, additional, and Kaneko, Takeshi, additional

Published
2015
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27. An Autopsy Case of Two Distinct, Acquired Drug Resistance Mechanisms in Epidermal Growth Factor Receptor-mutant Lung Adenocarcinoma: Small Cell Carcinoma Transformation and Epidermal Growth Factor Receptor T790M Mutation

Author

Furugen, Makoto, primary, Uechi, Kayoko, additional, Hirai, Jun, additional, Aoyama, Hajime, additional, Saio, Masanao, additional, Yoshimi, Naoki, additional, Kinjo, Takeshi, additional, Miyagi, Kazuya, additional, Haranaga, Shusaku, additional, Higa, Futoshi, additional, Tateyama, Masao, additional, and Fujita, Jiro, additional

Published
2015
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29. Interleukin-17A in Legionella pneumonia: A Retrospective Study

Author

Higa, Futoshi, primary, Haroon, Attiya, additional, Iha, Yoshikazu, additional, Tasato, Daisuke, additional, Nakamura, Hideta, additional, Kinjo, Takeshi, additional, Tamayose, Maki, additional, Furugen, Makoto, additional, Miyagi, Kazuya, additional, Haranaga, Shusaku, additional, Tateyama, Masao, additional, and Fujita, Jiro, additional

Published
2015
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30. Falciparum Malaria Incidentally Pretreated with Azithromycin

Author

Shibahara, Daisuke, primary, Kinjo, Takeshi, additional, Nishiyama, Naoya, additional, Kami, Wakaki, additional, Nabeya, Daijiro, additional, Haranaga, Shusaku, additional, Higa, Futoshi, additional, Tateyama, Masao, additional, Shinzato, Takashi, additional, Toma, Hiromu, additional, Kishimoto, Hidehiro, additional, and Fujita, Jiro, additional

Published
2015
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31. Pulmonary strongyloidiasis: assessment between manifestation and radiological findings in 16 severe strongyloidiasis cases.

Author

Daijiro Nabeya, Shusaku Haranaga, Parrott, Gretchen Lynn, Takeshi Kinjo, Saifun Nahar, Teruhisa Tanaka, Tetsuo Hirata, Akira Hokama, Masao Tateyama, Jiro Fujita, Nabeya, Daijiro, Haranaga, Shusaku, Kinjo, Takeshi, Nahar, Saifun, Tanaka, Teruhisa, Hirata, Tetsuo, Hokama, Akira, Tateyama, Masao, and Fujita, Jiro

Subjects
STRONGYLOIDIASIS, LUNG diseases, RADIOLOGY, SYNDROMES, PARASITIC diseases
Abstract

Background: Strongyloidiasis is a chronic parasitic infection caused by Strongyloides stercoralis. Severe cases such as, hyperinfection syndrome (HS) and disseminated strongyloidiasis (DS), can involve pulmonary manifestations. These manifestations frequently aid the diagnosis of strongyloidiasis. Here, we present the pulmonary manifestations and radiological findings of severe strongyloidiasis.Methods: From January 2004 to December 2014, all patients diagnosed with severe strongyloidiasis at the University of the Ryukyus Hospital or affiliated hospitals in Okinawa, Japan, were included in this retrospective study. All diagnoses were confirmed by the microscopic or histopathological identification of larvae. Severe strongyloidiasis was defined by the presence of any of the following: 1) the identification of S. stercoralis from extra gastrointestinal specimens, 2) sepsis, 3) meningitis, 4) acute respiratory failure, or 5) respiratory tract hemorrhage. Patients were assigned to either HS or DS. Medical records were further reviewed to extract related clinical features and radiological findings.Results: Sixteen severe strongyloidiasis cases were included. Of those, fifteen cases had pulmonary manifestations, eight had acute respiratory distress syndrome (ARDS) (53%), seven had enteric bacterial pneumonia (46%) and five had pulmonary hemorrhage (33%). Acute respiratory failure was a common indicator for pulmonary manifestation (87%). Chest X-ray findings frequently showed diffuse shadows (71%). Additionally, ileum gas was detected for ten of the sixteen cases in the upper abdomen during assessment with chest X-ray. While, chest CT findings frequently showed ground-glass opacity (GGO) in 89% of patients. Interlobular septal thickening was also frequently shown (67%), always accompanying GGO in upper lobes.Conclusions: In summary, our study described HS/DS cases with pulmonary manifestations including, ARDS, bacterial pneumonia and pulmonary hemorrhage. Chest X-ray findings in HS/DS cases frequently showed diffuse shadows, and the combination of GGO and interlobular septal thickening in chest CT was common in HS/DS, regardless of accompanying pulmonary manifestations. This CT finding suggests alveolar hemorrhage could be used as a potential marker indicating the transition from latent to symptomatic state. Respiratory specimens are especially useful for detecting larvae in cases of HS/DS. [ABSTRACT FROM AUTHOR]

Published
2017
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38. Hamman‐Rich syndrome revisited: how to avoid misdiagnosis

Author

Fujita, Jiro, Tohyama, Masato, Haranaga, Shusaku, Cash, Haley L., Higa, Futoshi, and Tateyama, Masao

Subjects
Acute interstitial pneumonia, Hamman‐Rich syndrome, pneumonia, Letters to the Editor, influenza, Letter to the Editor
Abstract

Please cite this paper as: Fujita et al. (2012) Hamman‐Rich syndrome revisited: How to avoid misdiagnosis. Influenza and Other Respiratory Viruses. DOI: 10.1111/j.1750‐2659.2012.00353.x.

Published
2012

39. Imported Malaria Cases in Okinawa Prefecture, Japan

Author

Higa, Futoshi, primary, Tateyama, Masao, additional, Tasato, Daisuke, additional, Karimata, Yosuke, additional, Nakamura, Hideta, additional, Miyagi, Kazuya, additional, Haranaga, Shusaku, additional, Hirata, Tetsuo, additional, Hokama, Akira, additional, Cash, Haley L., additional, Toma, Hiromu, additional, and Fujita, Jiro, additional

Published
2013
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42. Acquired Immune-deficiency Syndrome with Focal Onset of Mycobacterium avium Infection Displaying a Histological/Genetic Pattern of Disseminated Mycobacteria

Author

Hibiya, Kenji, primary, Tateyama, Masao, additional, Niimi, Masaki, additional, Teruya, Hiromitsu, additional, Karimata, Yousuke, additional, Hirai, Jun, additional, Tokeshi, Yoshihiro, additional, Haranaga, Shusaku, additional, Tasato, Daisuke, additional, Nakamura, Hideta, additional, Ihama, Yasushi, additional, Haroon, Attitya, additional, L. Cash, Haley, additional, Higa, Futoshi, additional, Hokama, Akira, additional, Ogawa, Kenji, additional, and Fujita, Jiro, additional

Published
2012
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46. Pulmonary Mycobacterium parascrofulaceum Infection as an Immune Reconstitution Inflammatory Syndrome in an AIDS Patient

Author

Teruya, Hiromitsu, primary, Tateyama, Masao, additional, Hibiya, Kenji, additional, Tamaki, Yuichiro, additional, Haranaga, Shusaku, additional, Nakamura, Hideta, additional, Tasato, Daisuke, additional, Higa, Futoshi, additional, Hirayasu, Tsuneo, additional, Furugen, Tomonori, additional, Kato, Seiya, additional, Kazumi, Yuko, additional, Maeda, Shinji, additional, and Fujita, Jiro, additional

Published
2010
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