A Case of Infectious Enteritis Caused by Verotoxin-producing Escherichia Coli O157

The subject was a 20-year-old male whose major symptoms were abdominal pains and loose stools. Since the FOM and antiflatulent that we prescribed for him did not improve his condition, he visited us again on the following day. A tumor in his right lower quadrant was identified with palpation, and lo...

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Published inNihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 26; no. 7; pp. 893 - 896
Main Authors Naito, Minoru, Nakahara, Ryuichi, Sou, Junichi, Inukai, Michio, Kajitani, Nobutani, Ujike, Yoshihito, Ino, Hideo, Murakami, Masakazu
Format Journal Article
LanguageJapanese
Published Japanese Society for Abdominal Emergency Medicine 2006
日本腹部救急医学会
Subjects
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ISSN1340-2242
1882-4781
DOI10.11231/jaem1993.26.893

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Abstract The subject was a 20-year-old male whose major symptoms were abdominal pains and loose stools. Since the FOM and antiflatulent that we prescribed for him did not improve his condition, he visited us again on the following day. A tumor in his right lower quadrant was identified with palpation, and localized muscular guarding was also present in the same region. In addition, an abdominal ultrasound test presented images similar to target signs and an abdominal CT scan revealed significant thickening of the ascending colon wall. Upon examination of the stool, O157 surface antigens turned out to be positive, and VT1 and VT2-producing Escherichia coli were found on the cultured stool sample. We therefore diagnosed his condition as an O157-induced infectious enteritis. In conclusion, we realized that it might be necessary to carry out examinations and treatments considering the possibility of O157-induced infectious enteritis when an imaging test finds significant localized thickening of the intestinal wall, even if no digestive symptoms such as frequent diarrhea and bloody stools are detected.
AbstractList The subject was a 20-year-old male whose major symptoms were abdominal pains and loose stools. Since the FOM and antiflatulent that we prescribed for him did not improve his condition, he visited us again on the following day. A tumor in his right lower quadrant was identified with palpation, and localized muscular guarding was also present in the same region. In addition, an abdominal ultrasound test presented images similar to target signs and an abdominal CT scan revealed significant thickening of the ascending colon wall. Upon examination of the stool, O157 surface antigens turned out to be positive, and VT1 and VT2-producing Escherichia coli were found on the cultured stool sample. We therefore diagnosed his condition as an O157-induced infectious enteritis. In conclusion, we realized that it might be necessary to carry out examinations and treatments considering the possibility of O157-induced infectious enteritis when an imaging test finds significant localized thickening of the intestinal wall, even if no digestive symptoms such as frequent diarrhea and bloody stools are detected.
The subject was a 20-year-old male whose major symptoms were abdominal pains and loose stools. Since the FOM and antiflatulent that we prescribed for him did not improve his condition, he visited us again on the following day. A tumor in his right lower quadrant was identified with palpation, and localized muscular guarding was also present in the same region. In addition, an abdominal ultrasound test presented images similar to target signs and an abdominal CT scan revealed significant thickening of the ascending colon wall. Upon examination of the stool, O157 surface antigens turned out to be positive, and VT1 and VT2-producing Escherichia coli were found on the cultured stool sample. We therefore diagnosed his condition as an O157-induced infectious enteritis. In conclusion, we realized that it might be necessary to carry out examinations and treatments considering the possibility of O157-induced infectious enteritis when an imaging test finds significant localized thickening of the intestinal wall, even if no digestive symptoms such as frequent diarrhea and bloody stools are detected. ベロ毒素を産生するO157感染性腸炎は極めて重篤な転帰をとることがある。われわれは頻回の下痢や血便がなく, 腹部超音波検査でtarget sign様の像をきたしていたため, 診断に苦慮したO157感染性腸炎の1例を経験した。症例は20歳男性。腹痛と軟便を主訴に来院した。FOMと整腸剤を処方されたが症状が改善しないため翌日に再来院した。右下腹部に腫瘤を触知し同部位に限局性の筋性防御があり, 腹部超音波検査でtarget sign様の像があり, 腹部CT検査で上行結腸の腸管壁が著明に肥厚していた。便検査からO157表面抗原陽性, 便培養でベロ毒素 (VT1, VT2) 産生大腸菌を検出したため, O157感染性腸炎と診断した。頻回の下痢や血便などの激しい消化器症状がない場合でも, 画像検査で限局性の著明な腸管壁の肥厚像があった場合には, O157感染性腸炎を考慮した検査や治療を行う必要がある。
Author Inukai, Michio
Naito, Minoru
Kajitani, Nobutani
Ujike, Yoshihito
Nakahara, Ryuichi
Murakami, Masakazu
Ino, Hideo
Sou, Junichi
Author_FL 村上 正和
宗淳 一
梶谷 伸顕
内藤 稔
伊野 英男
氏家 良人
中原 龍一
犬飼 道雄
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  fullname: Murakami, Masakazu
  organization: Department of Cancer and Thoracic Surgery, Okayama University Graduate School of Medicine and Dentistry
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DocumentTitleAlternate 軽微な症状しか示さなかったO157感染性腸炎の1例
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Nihon Fukubu Kyukyu Igakkai Zasshi
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日本腹部救急医学会
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References 6) Lopez EL, Devoto S, Woloj M, et al: Intussusception associated with Escherichia coli O157: H7. Pediatr Infect Dis 1989; 8: 471-473.
9) 加賀谷英生, 瀬田真祐, 佐々木勝海ほか: 腸重積との鑑別が困難であった腸管出血性大腸炎O157の1例. 日外感染症研 2003; 15: 222.
10) 厚生省: 一次, 二次医療機関のための腸管出血性大腸菌 (O157等) 感染症治療の手引き (改訂版) 厚生省97.
5) 堀木紀行, 丸山正隆, 藤田善幸, ほか: 感染性腸炎のCT検査所見. 日消病会誌 2002; 99: 925-934.
1) Konowalchuk J, Speirs JI, Stavric S, et al: Veroresponse to a cytotoxin of Escherichia coli. Infect Immun 1997; 18: 775-779.
7) 船田俊平: 腸管出血性大腸菌感染症による重篤な消化管合併症とその治療. 小児内科 1998; 30: 781-786.
2) Griffin PM, Ostroff SM, Tauxe RV, et al: Abstract Illnesses associated with Escherichia coli O157: H7 infections. A broad clinical spectrum. Ann Intern Med 1988; 705-12.
3) Friedland JA, Herman TE, Siegel MJ: Escherichia coli O157: H7-associated hemolyticuremic syndrome: value of coloniccolor Doppler sonography. Pediatr Radiol 1995; 25: 65-67.
8) 飯野年男, 加藤久美子, 高尾良彦, ほか: 成人の腸管出血性大腸菌O157感染症に合併した腸重積の1例. 日腹部救急医会誌2003; 23: 981-983.
4) 堀木紀行, 丸山正隆, 斎木茂樹, ほか: 著明な腸管壁の肥厚をCT上で確認しえた腸管出血性大腸菌O157: H7感染症の2例. 日消病会誌 1997; 94: 603-609.
References_xml – reference: 10) 厚生省: 一次, 二次医療機関のための腸管出血性大腸菌 (O157等) 感染症治療の手引き (改訂版) 厚生省97.
– reference: 2) Griffin PM, Ostroff SM, Tauxe RV, et al: Abstract Illnesses associated with Escherichia coli O157: H7 infections. A broad clinical spectrum. Ann Intern Med 1988; 705-12.
– reference: 7) 船田俊平: 腸管出血性大腸菌感染症による重篤な消化管合併症とその治療. 小児内科 1998; 30: 781-786.
– reference: 9) 加賀谷英生, 瀬田真祐, 佐々木勝海ほか: 腸重積との鑑別が困難であった腸管出血性大腸炎O157の1例. 日外感染症研 2003; 15: 222.
– reference: 5) 堀木紀行, 丸山正隆, 藤田善幸, ほか: 感染性腸炎のCT検査所見. 日消病会誌 2002; 99: 925-934.
– reference: 6) Lopez EL, Devoto S, Woloj M, et al: Intussusception associated with Escherichia coli O157: H7. Pediatr Infect Dis 1989; 8: 471-473.
– reference: 4) 堀木紀行, 丸山正隆, 斎木茂樹, ほか: 著明な腸管壁の肥厚をCT上で確認しえた腸管出血性大腸菌O157: H7感染症の2例. 日消病会誌 1997; 94: 603-609.
– reference: 8) 飯野年男, 加藤久美子, 高尾良彦, ほか: 成人の腸管出血性大腸菌O157感染症に合併した腸重積の1例. 日腹部救急医会誌2003; 23: 981-983.
– reference: 1) Konowalchuk J, Speirs JI, Stavric S, et al: Veroresponse to a cytotoxin of Escherichia coli. Infect Immun 1997; 18: 775-779.
– reference: 3) Friedland JA, Herman TE, Siegel MJ: Escherichia coli O157: H7-associated hemolyticuremic syndrome: value of coloniccolor Doppler sonography. Pediatr Radiol 1995; 25: 65-67.
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Snippet The subject was a 20-year-old male whose major symptoms were abdominal pains and loose stools. Since the FOM and antiflatulent that we prescribed for him did...
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SubjectTerms O157感染性腸炎
target sign
著明な長官壁肥厚
Title A Case of Infectious Enteritis Caused by Verotoxin-producing Escherichia Coli O157
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