敗血症16年間147例の検討-3-分離頻度の低い細菌による敗血症例について
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We reported previously an clinical analysis of the three quarters of 147 patients with septicemia due to six common organisms such as <I>E. coli</I>, α-streptococcus, <I>S. aureus, P. aeruginosa, K. pneumoniae</I> and <I>B. fragilis</I> during 16 years (1968-1983) in the vol.60, No. 5 of the journal of Japanese association for infectious disease. Among remaining one quarter of the patients due to rare organisms, there are not a few noteworthy instances in clinical practice. We now focused on such 39 patients in order to reveal clinical features.<BR>Causative organisms in these patients with septicemia consisted of 14 strains of non-fermentative Gram negative rods, 10 of Enterobacteriaceae, 4 of <I>Salmonella</I> species, 2 of <I>Neisseria species</I>, and one of <I>S. pneumoniae</I>. All these patients were suffered from septicemia due to single organism. Most of underlying diseases in these patients were non-fatal. Septicemia due to cocci, anaerobes, <I>C. perfringens</I> and <I>Salmonella</I> species were generally community acquired. On the other hand, those due to non-fermentatives and Enterobacteriaceae were hospital acquired. Non-fermentatives and Enterobacteriaceae have a tendency to cause shock. Mortality of these patients with septicemia due to rare organisms was 23% in contrast to the 33% due to common organisms. Among the former, mortality rate in patients with septicemia due to non-fermentatives and Enterobacteriaceae was high as the latter.<BR>There were many noteworthy instances of septicemia and infective endocarditis due to rare organisms such as <I>Peptostreptococcus</I> species, <I>N. mucosa, S. marcescens, F. meningosepticum, Ngonorrhoeae, A. hydrophila, A. calcoaceticus</I>, and <I>P. multocida</I>. A great majority of these cases had already reported in this journal and etc.
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