南予医学雑誌19巻

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田中、他：脾臓低形成を認めた糖尿病合併侵襲性肺炎球菌感染症の症例南予医誌　Vol.19　No. １　2019－59－Invasive pneumococcal infection in a patient with diabetes mellitus and splenic hypoplasia: A case report including a retrospective review of invasive pneumococcal infections in our hospitalAbstract　Anatomical splenicosis is a risk factor for invasive pneumococcal infection, but any association between an anatomically hypoplastic spleen and compromised splenic function remains unclear. We encountered an invasive pneumococcal infection in a patient with diabetes mellitus and a hypoplastic spleen.　A 60-year-old male complained of fever and waist/back pain 5 days in duration when he visited a local hospital. He exhibited a high-level inflammatory response and hepatic/renal dysfunction, and was transferred to our hospital in an emergency vehicle. Pneumococcus was detected in blood and sputum cultures; we diagnosed an invasive pneumococcal infection. Computed tomography revealed splenic hypoplasia. Purulent spondylitis also developed; orthopedic surgery/long-term antibiotic administration successfully resolved this issue.　Twenty-five cases of invasive pneumococcal infection (including this case) encountered in our hospital over the past 10 years were retrospectively evaluated. Mortality was high in patients with splenic hypoplasia and diabetes mellitus, but the number of cases was small; statistically significant differences were not evident. Patients with splenic hypoplasia may be particularly vulnerable to invasive infections by capsular pathogens such as pneumococci; careful treatment is thus necessary.（Nan-yo Med J 2019; 19: 53-59.）Keywords: invasive pneumococcal infection, splenic hypoplasiaTakemichi TANAKA1), Hideyuki NAKANISHI2), Hisaharu SHIKATA2),Masahiko KANEKO2)1) Postgraduate Clinical Training Center2) Department of Hematology　 Uwajima City Hospital　 Goten-machi, Uwajima, Ehime 798-8510, Japan