A Case of Staphylococcal Bacteremia Associated with Endocarditis and Disseminated Pneumonia Induced by Nonaseptic Intravenous Abuse of Aminophyllin and Prednisolone
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A 37-year-old woman was admitted with remittent fever of one month duration. The temperature rose as high as 40°C with shaking chills. There were needle tracks along veins of her bilateral cubital fossae. A blood culture on admission had grown a penicillin-resistant Staphylococcus aureus. X-ray films of the chest revealed small scattered areas of consolidation simulating bronchopneumonia in both lung fields. Thin-walled cavities were also found in some parts of the shadows. Because of her intractable bronchial asthma, initiated of the age of eighteen, she had used to perform intra-venous injections of 'NEOPHYLLIN' (2.5% aminophyllin, 10ml Amp.) by herself since thirty years old until quite recently. She also used 'CODELSOL' (prednisolone phosphoric acid ester 20mg/ml, 2ml Amp.) for about two years till six months before the admission. Those drugs were gotten from a certain drug store at the suggestion of a friend. As the method of injection was not completely clean, it is easy to suppose that the staphylococcall infection occured through the injection site. The use of corticosteroid also had to be an important factor in the development to endocarditis and a pneumonia secondary to hematogenous spread of the bacteria. She was treated with intensive chemotherapy and almost completely recovered about eight weeks after admission, except the remaining complication of valvular damage (without insufficiency). The use of oxacillin and gentamicin seemed to be most effective, as is indicated by previous reports.
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社団法人 日本呼吸器学会 | 論文
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