title: Bacteremic and leukopenic pneumococcal pneumonia: successful treatment with antibiotics, pulse steroid, and continuous hemodiafiltration.
abstract: 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.
authors.affiliation: First Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan. yokoyama-t@nyc.odn.ne.jp
authors.forename: Toshinobu
authors.initials: T
authors.lastname: Yokoyama
authors.forename: Teruo
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Norihiko
authors.initials: N
authors.lastname: Shida
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Shimada
authors.forename: Nobuo
authors.initials: N
authors.lastname: Kaku
authors.forename: Hisamichi
authors.initials: H
authors.lastname: Aizawa
authors.forename: Kotaro
authors.initials: K
authors.lastname: Oizumi
mesh_terms: 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
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents