Pasteurella multocidaによる膿胸の1剖検例と文献的考察

概要

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Pasterurella multocida (P. multocida) is well recognized as the causative agent of hemorrhagic septicemia and respiratory infections in animals. Recently, various infections due to P. multocida in human have been noted. Among them respiratory infections are unsual, and empyema is very rare. We report here the first case of P. multocida empyema in Japan, which is considered to be the 16th case in the English literatures. A 78 year-old male farmer, suffered with high fever, productive cough and left chest pain, was admitted to our hospital 5 days after onset. Left pleural effusion and acute inflammatory reactions were shown. P. multocida was isolated alone from the bloody pleural fluid on the first hospital day. The administration of sulbenicillin, following cephaloridine, resulted in clinical improvement. Then cyclophosphamide therapy was started on the 4th hospital week, because the patient had been diagnosed as IgGκ type of multiple myeloma. But soon later the patient died suddenly of unkown cause. On autopsy, invasions of atypical plasma cell were found in the bone marrow and the spleen, but little in the other organs. In the lungs, chronic bronchitis was revealed, but the empyema was cured following fibrosis of the pleura. It was considered that latent respiratory truct infection due to P. multocida brought the patient with multiple myeloma and chronic bronchitis to the empyema.
日本感染症学会の論文