Evans syndrome associated with Salmonella enteritidis bacteremia during administration of prednisolone.

概要

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A 17 year-old man was admitted to Yokohama Rosai Hospital because of severe anemia and high serum level of LDH on September 4, 1992. He was diagnosed as Evans syndrome by clinical laboratory data. On sixth day after administration of 40mg/day of Prednisolone (PSL), he was fevered up to 38°C and group O 9 Salmonella was detected from his blood. The bacteria was determined as S. enteritidis by serotype with Vi (-), O-9, H-g. Stool culture was negative. Although fever was down after administration of amikacin sulfate (AMK) and fosfomycin (FOM), he was fevered up again following of methyl-PSL pulse therapy which was done for his low platelet count (4.3×104/μl) . Then aztreonam (AZT) and cefoperazone sodium (CPZ) were administered, and he had never been relapsed. As is known that healthy Salmonella carriers are gradually increased, a happens of non-typhoidal Salmonella bacteremia may be considered to occur in patients with impaired cellular immune system by basic disease or its treatment.
日本臨床免疫学会の論文