title: [A case of bacterial pneumonia caused by Streptococcus dysgalactiae subsp. equisimilis, showing patchy consolidations resembling organizing pneumonia].
abstract: In December, 2001, a 67-year-old woman was given a diagnosis of having systemic sclerosis and organizing pneumonia. Steroid treatment improved her condition, and she received no further medication for approximately three years thereafter. In October 2005, she visited Kurume University Hospital because of cough and fever. Chest X-ray film and high-resolution computed tomography (HRCT) showed bilateral patchy consolidation with air-bronchogram sign and ground-glass opacities, predominantly in the right lower lung field, suggesting relapse of organizing pneumonia. However, bronchoalveolar lavage fluid (BALF) analysis showed an increase of neutrophils (79%) and the CD4/CD8 ratio (4.04). Streptococcus dysgalactiae subsp. equisimilis (beta-hemolytic, Lancefield group G) was detected by bacterial culture of the BALF. Treatment with sulbactam sodium/ampicillin sodium (SBT/ ABPC) rapidly improved her symptoms. The patchy consolidations on chest X-ray and HRCT also disappeared after the treatment. On the basis of these clinical and bacteriological findings, we diagnosed the patient as having bacterial pneumonia caused by Streptococcus dysgalactiae subsp. equisimilis.
authors.affiliation: Department of Internal Medicine 1. Kurume University School of Medicine.
authors.forename: Daisaku
authors.initials: D
authors.lastname: Matsui
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Kitasato
authors.forename: Seiyo
authors.initials: S
authors.lastname: Honda
authors.forename: Keiko
authors.initials: K
authors.lastname: Ueno
authors.forename: Atsutoshi
authors.initials: A
authors.lastname: Tanaka
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Edakuni
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Mukaino
authors.forename: Munetsugu
authors.initials: M
authors.lastname: Nishimura
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Kawayama
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Hoshino
authors.forename: Kiminori
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Takeharu
authors.initials: T
authors.lastname: Koga
authors.forename: Hisamichi
authors.initials: H
authors.lastname: Aizawa
mesh_terms: D000368:Aged; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology*; D018549:Cryptogenic Organizing Pneumonia / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D018410:Pneumonia, Bacterial / Q000000981:diagnostic imaging / Q000382:microbiology*; D013902:Radiography, Thoracic; D013290:Streptococcal Infections / Q000000981:diagnostic imaging / Q000382:microbiology*; D013291:Streptococcus / Q000302:isolation & purification*; D014057:Tomography, X-Ray Computed