糖尿病における重症感染症 : 本邦報告例568例の集計

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Severe infections in diabetic patients of reported 568 cases in Japan were reviewed. Diabetic control was poor in patients in this series ; blood glucose level (M±SD) was 375.0±260.5mg/dl (305cases) and HbA 1c level 11.0±3.0% (256 cases). Fifty-eight cases in 568 cases were deceased. Renourological, hepatobiliary, musculofascial and pulmonary infections, suppurative spondylitis and sepsis accounted for 73% of all cases. In musculofascial infection, cases with psoas abcess were preponderance. Cases with hepatic abcess were also preponderance and main causative organism was Klebsiella in the hepatic abcess. Organ emphysematous infection and gas gangrene were observed in 119 cases (21%) in this series and most of causative organisms was nonclostridial ; infections by clostridium were only 8 cases. Numerous cases of emphysematous pyelonephritis, gas gangrene of lower legs and feet, hepatic gas abcess, emphysematous cystitis and emphysematous cholecystitis were present. Gas gangrene was observed in some cases of Fournier's gangrene. Main causative organisms of infections in this series were staphyllococcus including increasing incidence of MRSA, Klebsiella, E.coli and streptcoccus and these organisms accouted 69% of all bacterial organisms. Bacteroides, AFB, Enterococcus, Pseudomonas, Peptostreptococcus and Prevotella were detected in considerable number. Causative pathogens by normal bacterial flora in the human or domestic animal oral cavity and skin and other many opportunistic pathogens were detected extensively in the infected areas. Candidiasis was prominent in the fungal infections. Rhinocerebral mucormycosis and malignant external otitis which were strongly associated with diabetes were reported only 2 and 1 cases, respectively.
香川県立保健医療大学の論文

糖尿病における重症感染症 : 本邦報告例568例の集計

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