ABSTRACT
Procalcitonin (PCT) was initially described as a calcitonin prohormone and later shown to be a useful marker for identifying bacterial infection and sepsis. We evaluated PCT's clinical efficacy in assessing bacterial infection severity, measuring PCT and systemic inflammatory response syndrome (SIRS) markers in 180 subjects with suspected infection. PCT titer was higher with increasing infection severity. PCT was thus useful in identifying those in critical condition.
Subject(s)
Biomarkers/blood , Calcitonin/blood , Protein Precursors/blood , Systemic Inflammatory Response Syndrome/blood , Adult , Aged , Aged, 80 and over , Calcitonin Gene-Related Peptide , Female , Humans , Male , Middle Aged , Sepsis/bloodABSTRACT
A 90-year-old woman was referred and admitted to our hospital because of progressing dementia, decreased appetite, and general fatigue. Blood tests on admission disclosed: white cell count, 2,900 /mm(3); hemoglobin 5.6 g/dl; mean corpuscular volume; 139.7 microm(3). Based on the presence of pancytopenia, macrocytic anemia, and elevated lactate dehydrogenises, we suspected pernicious anemia. We administered vitamin B12, which improved the blood test results and the signs of dementia. Gastrointestinal tract examination showed type A gastritis. Tests for anti-intrinsic factor antibody and anti-gastric parietal cell antibody were positive, which help confirm a diagnosis of pernicious anemia. Pernicious anemia is an autoimmune disease common among those aged 50-60 years. Cases aged over 90 years are rare. However, the numbers of extremely elderly patients are expected to increase with the growth of the elderly population. Fortunately, pernicious anemia is easy to treat. We need to make an appropriate diagnosis of pernicious anemia in the oldest elderly patients.
Subject(s)
Anemia, Pernicious/complications , Gastritis/etiology , Aged, 80 and over , Anemia, Pernicious/drug therapy , Dementia/etiology , Female , Heart Failure/etiology , Humans , Vitamin B 12/therapeutic useABSTRACT
Clostridium perfringens (C.P) gas gangrene is one of the most fulminant infectious diseases. We encountered fulminant massive gas gangrene in a 56- year-old man with alcoholic liver cirrhosis. The patient died 14 hours after diagnosis of gas gangrene (54 hours after admission). Dramatic changes in abdominal CT imaging revealed development of a massive volume of gas in the intra-portal vein, retroperitoneum and abdominal subcutaneous tissue within 24 hours. We also proved C.P infection by immunohistological staining, leading to a diagnosis of C.P gas gangrene.
