人工呼吸管理により救命し, BALFより起炎菌を分離しえた重症オウム病の1例

谷口 治子; 迎 寛; 飯干 宏俊; 芦谷 淳一; 伊井 敏彦; 坂本 晃; 増本 英男; 松倉 茂; 田中 宏典; 河野 茂

doi:10.11150/kansenshogakuzasshi1970.69.1396

A Case of Fulminant Psittacosis Necessitating Mechanical Ventilation Diagnosed by Chlamydial Isolation form BALF

Haruko TANIGUCHI, Hiroshi MUKAE, Hirotoshi IHIBOSHI, Jun-ichi ASHITANI, Toshihiko IHI, Akira SAKAMOTO, Hideo MASHIMOTO, Shigeru MATSUKURA, Hironori TANAKA, Shigeru KOHNO

Author information

Haruko TANIGUCHI
The Third Department of Internal Medicine, Miyazaki Medical College
Hiroshi MUKAE
The Third Department of Internal Medicine, Miyazaki Medical College
Hirotoshi IHIBOSHI
The Third Department of Internal Medicine, Miyazaki Medical College
Jun-ichi ASHITANI
The Third Department of Internal Medicine, Miyazaki Medical College
Toshihiko IHI
The Third Department of Internal Medicine, Miyazaki Medical College
Akira SAKAMOTO
The Third Department of Internal Medicine, Miyazaki Medical College
Hideo MASHIMOTO
The Third Department of Internal Medicine, Miyazaki Medical College
Shigeru MATSUKURA
The Third Department of Internal Medicine, Miyazaki Medical College
Hironori TANAKA
Department of Laboratory Medicine, Nagasaki University School of Medicine
Shigeru KOHNO
The Second Department of Internal Medicine, Nagasaki University School of Medicine

Keywords: psittacosis, BALF

JOURNAL FREE ACCESS

1995 Volume 69 Issue 12 Pages 1396-1401

DOI https://doi.org/10.11150/kansenshogakuzasshi1970.69.1396

Details

Abstract

A 51-year-old female was admitted with complaints of fever and general fatigue. Chest X-ray showed diffuse bilateral fine nodular shadows and infiltrates. Complication of hepatic and muscular injury was suspected from increased levels of GOT, GPT and CPK in the seurm. Arterial blood gas analysis revealed hypoxemia. Because hypoxemia aggravated despite treatment with intravenous minocycline (200 mg/day), corticosteroids and mechanical ventilation were started, and the administration of minocycline (400 mg/day) and sparfloxacin was added. Consequent, chest X-rays and several laboratory data improved gradually. The final diagnosis was established with a significant rise of both IgG and IgM antibody against Chlamydia psittaci with MIF and identification of Chlamydia with the cell culture method. Chlamydia was successfully isolated from BALF of this patient obtained 5 days after commencement of minocycline treatment.
Psittacosis should be considered as a possible cause of severe respiratory failure necessitating emergency care including mechanical ventilation.

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