Candida Glabrata Fungemia After Amputation of an Infected Diabetic Foot

概要

論文の詳細を見る
A 58-year-old woman suffered from left pyelonephritis with diabetic triopathy on admission at whichtime a double J stent was inserted in the left ureter and was left untreated for a year. She was admitteddue to fever,thirst,polydipsia,polyuria and,left 1,2-toe ulcer and vacuole. We diagnosed diabetic footinfections. We used 6g of ampicillin-sulbactum and 40μg of alprostadil alfadex daily in addition to dietand insulin therapy for diabetes mellitus. As the toe lesion deteriorated, a left foot amputation wasperformed at the 11th day. The subfever continued and the consciousness level deteriorated from alertto 100 on the Japan coma scale and acute respiratory failure occurred 21 days after operation. Wholebody computed tomography showed invasive lesions in bilateral pulmonary lower lobes and renal pelvicdilatation and perirenal abscess in left kidney indicating renal abscess. Milk-like urine was excreted.Urine and blood culture detected Candida glabrata. Fundoscopic exam showed retinal exudates indicatingmycotic endophthalmitis. We diagnosed candida glabrata sepsis from pyelonephritis. After using200mg of micafungin daily, the patient recovered. In addition to exchanging the stent, treatment ofdiabetes mellitus is important for the prevention of severe infection.
北関東医学会の論文