[A case of septic shock due to pneumonia caused by Klebsiella pneumoniae].
A 51-year-old male, who had a history of excessive drinking and chronic hepatitis, was admitted to our hospital because of high fever and shock. Physical examinations, chest X-ray films and hemodynamic data revealed that he had progressed to septic shock due to pneumonia. Combination chemotherapy of latamoxef plus piperacillin was immediately started. After Klebsiella pneumoniae was isolated from bronchoalveolar lavage fluid, the antibiotics were changed to ceftizoxime plus amikacin. Furthermore human gamma globulin preparations and frozen fractional plasma were administered because of granulocytopenia and a decrease in complement. Gabexate mesylate, methylprednisolone (MP) and branched chain amino acids were given to prevent disseminated intravascular coagulation and/or multiple organ failure. With this intensive care, he recovered from shock and pneumonia. The effects of MP on the whole blood chemiluminescence (CL) were examined. Incubation of whole blood with 25, 50 or 100 micrograms/ml of MP for 10 to 60 minutes had no effects on the CL response. This indicates that MP does not affect the production of reactive oxygen species from phagocytic cells at concentrations comparable to those used in drug therapy.
Baba
M
M
Ono
Y
Y
Ueda
Y
Y
Haga
T
T
Nozue
N
N
Nishiya
H
H
Kunii
O
O
D006801:Humans; D007710:Klebsiella Infections / Q000150:complications*; D007711:Klebsiella pneumoniae; D008297:Male; D008775:Methylprednisolone / Q000494:pharmacology; D008875:Middle Aged; D010586:Phagocytes / Q000187:drug effects / Q000276:immunology; D011014:Pneumonia / Q000150:complications*; D012772:Shock, Septic / Q000209:etiology*
D008775:Methylprednisolone