Fatal Severe Fever with Thrombocytopenia Syndrome Virus and Pasteurella multocida Coinfection.

We herein report a case of severe fever with thrombocytopenia syndrome (SFTS) with Pasteurella multilocida bacteremia in a 65-year-old man with alcoholic cirrhosis who was admitted to our hospital with anorexia and severe fatigue. Laboratory tests revealed pancytopenia and liver and kidney dysfunction. After admission, he developed impaired consciousness, mucosal hemorrhaging, and septic shock. SFTS virus was detected on polymerase chain reaction testing of blood and throat swabs, and Pasteurella multocida was detected on blood culture. Despite being treated with invasive mechanical ventilation, vasopressors, and antibiotics, the patient's condition progressively deteriorated, and he died four days after admission.

Early esophageal cancer with epidermization diagnosed and treated with endoscopic resection.

The patient was a 57-year-old man who had undergone endoscopic submucosal dissection for early esophageal cancer (distance from incisor tooth, 30 cm) when he was 50 years of age. Pathological findings showed squamous cell carcinoma invading the lamina muscularis mucosae and mild lymphatic invasion. Considering the possibility of lymph node metastasis and distant metastasis, we administered radiation chemotherapy (CDDP+ 5-FU, total radiation 41.4 Gy) in the same year. Two years later, follow-up endoscopy revealed a white, flat, elevated lesion in the thoracic esophagus (distance from incisor tooth, 36 cm) that was not stained by Lugol's iodine. A biopsy of this lesion was performed. Although esophageal epidermization was seen, there were no findings suggestive of malignancy. The lesion grew slightly during four and a half years of follow-up after identification. We performed a repeat biopsy of the lesion, and the tissue was diagnosed as atypical epithelium, so we performed endoscopic mucosal resection for diagnostic and therapeutic purposes. The postoperative pathological diagnosis was squamous cell carcinoma of T1a-LPM with epidermization due to its histological features. To the best of our knowledge, this is the first report of esophageal cancer accompanied by epidermization.