PMID: 9658323Jul 11, 1998Paper

Fulminant hepatitis complicated by small intestine infection and massive hemorrhage

Journal of Gastroenterology
H TamuraF Murakami

Abstract

A 34-year-old man diagnosed with fulminant hepatitis, caused by hepatitis B virus, and acute renal failure was referred to our hospital. After admission to the intensive care unit, the liver and renal failure were ameliorated. Melena requiring transfusion occurred during the course of his illness. Endoscopic examination demonstrated pseudomembranes, erosions, ulcers, and hemorrhage in the duodenum, the upper jejunum, and the terminal ileum, suggesting widespread lesions throughout the small intestine. Pseudomonas putida, Xanthomonas maltophilia, and Candida glabrata were cultured from ileal fluid. Candida glabrata was also detected in sputum, feces, and on an intravenous catheter tip. The patient was treated with amphotericin B and miconazole. The melena was ameliorated, but inflammation of the small intestine persisted. Although we had difficulty in treating the enteritis, the patient survived, and 1 year later colonoscopic examination demonstrated no abnormalities. The small intestine is a difficult site to examine, but endoscopic examination of this site is important when massive hemorrhage develops.

Citations

Jun 10, 2011·Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy·Naoto TakahashiKenichi Sawada
May 28, 2014·FEMS Microbiology Reviews·Mirjana Rajilić-Stojanović, Willem M de Vos
Nov 14, 2018·Infectious Diseases·Angelina Trifonova, Tanya Strateva

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