糖尿病に合併した重症感染症による死亡症例の検討 : 本邦報告例70症例について

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A clinical observation was carried out in 70 deceased diabetic patients with severe infections. Seven hundred fifty-six cases with severe infections had been reported in Japan since 1988 and 70 cases were deceased ; mortality rate was 9.3%. In the deceased cases, average age was 63. 9 year-old and duration of diabetes 12.7 years, mean blood glucose level 429.5 mg/dl and glycohemoglobin (HbAlc) 10.6%. Forty-seven cases had two or more infected foci. The highest incidence of infections in this series was sepsis which was accompanied by one or more other infected foci. Also high incidences were observed in respiratory, urological and musculo-fascial infections. Suppurative meningitis and peritonitis, hepatobiliary infections and Fournier's gangrene were causative diseases of death in considerable cases. Fatal cases were seen in some cases with brain abscess, suppurative spondylitis, rhinocerebral fungal infections, endocarditis and panorbititis. The gas forming infections were observed in 15 cases (21.4%). Most frequently detected pathogens were Klebsiella and Candida as well as Staphylococci including MRSA and CNS. Streptococci, E. coli, Salmonella, Clostridium, Enterobacter, AFB and many opportunistic pathogens such as Pseudomonas and Proteus were detected frequently. The opportunistic pathogens were usually contaminated with one or more other pathogens. The most of deceased cases had serious complications. Those included cardiovascular diseases, renal failure, digestive organ failure, diabetic coma, malignant tumors, respiratory diseases, DIC and MOF.
香川県立保健医療大学の論文

糖尿病に合併した重症感染症による死亡症例の検討 : 本邦報告例70症例について

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