黄色ブドウ球菌髄膜炎にて死亡したインスリン非依存型糖尿病の1症例

概要

論文の詳細を見る
A 65-year-old woman with a 25-year history of poorly controlled non-insulindependent diabetes mellitus was admitted complaining arthralgia, fever, visual disturbance and dysarthria. At admission consciousness was normal and apart from signs associated with peripheral neuropathy no abnormal neurological findings appeared. She showed systolic heart murmurs at intercostal space IV and diabetic retinopathy (Scott V). Over the years gangrenous changes had occurred bilaterally in the feet and diabetic gangrenes exuding purulent discharge were found in both feet. The third day in hospital the patient developed nuchal ridigity, and furthermore, laboratory analyses disclosed the presence of staphylococcus aureus in the blood, in the cerebrospinal fluid and in the purulent discharge from the gangrenes. Although intensive antibiotic and intravenous insulin infusion therapy achieved a few days of temporary amelioration, consciousness began to wane and eventually the patient became hypotensive and unconscious, showing signs of disseminated intravascular coagulation. She died the 23rd day in hospital. Autopsy was not permitted. Out of 46 adults treated for acute bacterial meningitis at Kitasato University Hospital between 1971 and 1990, only 2 (4.4%) had staphylococcus aureus meningitis the present case is the only one to date implicating diabetes mellitus.
北里大学の論文
1990-10-31