ID | 66860 |
フルテキストURL | |
著者 |
Fukushima, Shinnosuke
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Hagiya, Hideharu
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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Kaken ID
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Honda, Hiroyuki
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Ishida, Tomoharu
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Shoji, Ryohei
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Hasegawa, Kou
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Otsuka, Fumio
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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publons
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抄録 | Escherichia coli-associated native-valve infective endocarditis is a rare disease that affects elderly patients with underlying risk factors such as diabetes mellitus, malignancy, and renal failure. Long-term use of calcium polystyrene sulfonate is a potential risk factor for gastrointestinal mucosal damage or even colorectal ulcers. Herein, we describe a fatal case of a 66-year-old Japanese man with diabetes mellitus and renal failure who was prescribed calcium polystyrene sulfonate (CPS) for 11 years and developed a CPS-induced rectal ulcer, leading to E. coli native-valve infective endocarditis. The patient was admitted to our hospital due to acute-onset impaired consciousness. As a result of the systemic investigation, he was diagnosed with E. coli bacteremia accompanied by multiple cerebral infarctions and an acute hemorrhagic rectal ulcer. Transesophageal echocardiography revealed a 20-mm vegetative structure on the mitral valve, resulting in a final diagnosis of E. coli-associated infective endocarditis. After rectal resection, mitral valve replacement surgery was performed; however, the patient died shortly after surgery. Pathological findings of the resected rectum showed deposition of a basophilic crystalline material suggesting the presence of CPS. Our case highlights the potential risk of colorectal ulcers in a long-term CPS user, which can trigger bacterial translocation and endocarditis as fatal complications.
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キーワード | Bacteremia
Calcium polystyrene sulfonate
Escherichia coli
Infective endocarditis
Rectal ulcer
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備考 | The version of record of this article, first published in Clinical Journal of Gastroenterology, is available online at Publisher’s website: http://dx.doi.org/10.1007/s12328-024-01949-4
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発行日 | 2024-03-25
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出版物タイトル |
Clinical Journal of Gastroenterology
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巻 | 17巻
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号 | 3号
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出版者 | Springer Science and Business Media LLC
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開始ページ | 472
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終了ページ | 476
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ISSN | 1865-7257
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資料タイプ |
学術雑誌論文
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言語 |
英語
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OAI-PMH Set |
岡山大学
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著作権者 | © The Author(s) 2024
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論文のバージョン | publisher
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PubMed ID | |
DOI | |
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関連URL | isVersionOf https://doi.org/10.1007/s12328-024-01949-4
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ライセンス | http://creativecommons.org/licenses/by/4.0/
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Citation | Fukushima, S., Hagiya, H., Honda, H. et al. Calcium polystyrene sulfonate-induced rectal ulcer causing E. coli native-valve infective endocarditis. Clin J Gastroenterol 17, 472–476 (2024). https://doi.org/10.1007/s12328-024-01949-4
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助成機関名 |
Okayama University
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