Bacteremic and leukopenic pneumococcal pneumonia: successful treatment with antibiotics, pulse steroid, and continuous hemodiafiltration.
We describe a case of bacteremic, leukopenic pneumococcal pneumonia with respiratory failure, accompanied by diabetic ketoacidosis and hypothermia. Pulmonary leukostasis may play a role in the pathogenesis of the acute respiratory distress syndrome (ARDS) in pneumococcal pneumonia. The patient recovered with mechanical ventilation, intravenous antibiotics, pulse-steroid therapy, and continuous hemodiafiltration (CHDF). In particular, administration of steroid and the use of CHDF may improve the status of pulmonary leukostasis in leukopenic pneumococcal infection.
Yokoyama
Toshinobu
T
First Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan. yokoyama-t@nyc.odn.ne.jp
Sakamoto
Teruo
T
Shida
Norihiko
N
Shimada
Toshifumi
T
Kaku
Nobuo
N
Aizawa
Hisamichi
H
Oizumi
Kotaro
K
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000628:therapy*; D017583:Hemodiafiltration; D006801:Humans; D007970:Leukopenia / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011018:Pneumonia, Pneumococcal / Q000628:therapy*; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000628:therapy
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents