{"created":"2023-06-20T15:52:51.879813+00:00","id":7221,"links":{},"metadata":{"_buckets":{"deposit":"98c36619-8d07-491d-9f4d-aedf09137bc5"},"_deposit":{"created_by":34,"id":"7221","owners":[34],"pid":{"revision_id":0,"type":"depid","value":"7221"},"status":"published"},"_oai":{"id":"oai:redcross.repo.nii.ac.jp:00007221","sets":["195:197:201"]},"author_link":["25950","25957","25953","25948","25955","25954","25949","25956","25952","25951","25958"],"item_10002_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2012-12","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"66","bibliographicPageStart":"61","bibliographicVolumeNumber":"37","bibliographic_titles":[{"bibliographic_title":"松山赤十字病院医学雑誌"}]}]},"item_10002_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"Clostridium perfringensにより激しい血管内溶血を起こし、短時間で死亡した症例を経験したので報告する。症例は41歳男性。胃癌の再発に対し、1ヵ月前まで化学療法を受けていた。今回、腹痛を主訴に来院し、癌性疼痛の増悪と診断され緊急入院となった。入院時に著変を認めなかった検体検査は入院翌日に著明な異常値を示し、患者は吐血、黄疸をはじめ、状態の急激な悪化をきたし、来院から32時間で死亡した。入院翌日に3回提出された採血検体はいずれも強溶血を呈していた。微生物検査にて、CBC検体からClostridium perfringensを、血液培養(好気ボトル)からAeromonas hydrophila groupを分離した。分離したC.perfringensとA.hydrophila groupを健常者血液にそれぞれ接種し、培養した結果、C.perfringensを接種した検体で溶血を認めた。この結果より本例の激しい血管内溶血はC.perfringensによって惹起されたと考えられた。C.perfringens敗血症は致死率の非常に高い感染症で、短時間で死に至るため、菌の培養同定検査を待ってからの処置では救命し得ない。患者救命のためには患者の検体および結果を最初に目にする我々が血管内溶血と判断し、敗血症所見やプロカルシトニン(PCT)の上昇を認めた場合はC.perfringens敗血症と推定することが重要である。検査情報を的確に判断し、迅速に医師に伝えることで早期診断・治療に貢献し、救命率向上の一役を担いたいものである。(著者抄録)","subitem_description_type":"Abstract"}]},"item_10002_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{}]},"item_10002_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0385-3888","subitem_source_identifier_type":"ISSN"}]},"item_10002_version_type_20":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"土手内, 靖"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"福永, 真紗美"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"杉原, 崇大"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"高橋, 諭"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"尾崎, 牧子"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"西山, 記子"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"谷松, 智子"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"西山, 政孝"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"白石, 猛"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"松井, 完治"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"横田, 英介"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2015-03-26"}],"displaytype":"simple","filename":"土手内先生-144.pdf","filesize":[{"value":"774.0 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"matsuyama00023","url":"https://redcross.repo.nii.ac.jp/record/7221/files/土手内先生-144.pdf"},"version_id":"81c3a54b-75ac-45c8-b523-1b47d6b62a45"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"Clostridium perfringens","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"intravascular hemolysis","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"fulminant infection","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"sepsis","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"高度の血管内溶血を合併したClostridium perfringensの劇症感染に関する検討","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"高度の血管内溶血を合併したClostridium perfringensの劇症感染に関する検討"}]},"item_type_id":"10002","owner":"34","path":["201"],"pubdate":{"attribute_name":"公開日","attribute_value":"2015-03-26"},"publish_date":"2015-03-26","publish_status":"0","recid":"7221","relation_version_is_last":true,"title":["高度の血管内溶血を合併したClostridium perfringensの劇症感染に関する検討"],"weko_creator_id":"34","weko_shared_id":-1},"updated":"2023-06-20T20:14:47.569220+00:00"}