日本 化 学療 法 学 会 雑 誌 262 JULY 血 球 数8,700/μl,CRP (症例2) 64歳 の男 性 1980年 ご ろ よ り慢 性 肺 気 腫 と診 断 さ れ て い る 本症 例 は まず1993年 に 喀 痰 細 胞 診Class皿 と 認 め られ た が,こ 5.0m

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VOL.46 NO.7 Eikenella corrodens Key words: Eikenella corrodens,

日本 化 学療 法 学 会 雑 誌 262 JULY 血 球 数8,700/μl,CRP (症例2) 64歳 の男 性 1980年 ご ろ よ り慢 性 肺 気 腫 と診 断 さ れ て い る 本症 例 は まず1993年 に 喀 痰 細 胞 診Class皿 と 認 め られ た が,こ 5.0mg/dlと 1990 炎症 反 の充 進 も れ らの 炎 症 所 見 は 自然 紅 過 で 正 常 化 した 入 院 時 お よ び 経 過 中 の 喀 痰 培 養 で は 有 意 菌 は 検 な り,左 肺 尖 部 に 空 洞 が 指 摘 さ れ た た め 外 来 で 気 管 支 出 さ れ な か っ た 胸 部X線 で は左 肺 尖 部 に 壁 不 整 を伴 う 鏡 を 施 行 し た が 異 常 な く経 過 観 察 と な っ た と こ ろ が 空 洞 が 認 め られ た(Fig.1-B) 入 院 後,左 に対 し て気 管 支 鏡 検 査 を2回 施 行 し た が,細 1994年 に再 度 喀 痰 細 胞 診Class皿 とな り,左 肺 尖 部 陰 肺 尖部病 変 胞 診,組 影 も増 強 し て い る た め精 査 目的 で 仙 台 厚 生 病 院 へ 入 院 織 診,細 とな っ た 入 院 時 に は37.6 2回 目の 気 管 支鏡 検 査 施 行 後 か ら再 び 発 熱 が み られ る よ の 発 熱 が み られ,ま た 白 A; case 1 菌 学 的 検 索 と も に有 意 所 見 は得 ら れ な か っ た B; case 2 C; case 3 Fig. 1. Chest radiograph of the patients on admission. Case 1: Figure 1-A, Case 2: Figure 1-B, Case 3: Figure Table 1. Semi-quantitative Microbiology Susceptibility of Eikenella corrodens MICs of each agent were measured Systems), according to the standard S: susceptible, of isolates and susceptibility to antimicrobial by Septer were judged System I: intermediate, agents (Becton Dickinson from the breakpoint of NCCLS. MS: moderately susceptible, 1-C R: resistant of each agent

VOL.46 NO.7 Eikenella corrodens E. corrodens E. corrodens E. corrodens piperacilin, cefamandole, imipenemlcilastatin E. corrodens Table 2. Case of pulmonary infections due to Eikenella corrodens reported in Japan m: male, f: female CEZ: cefazolin, CTM: cefotiam, LCM: lincomycin, EM: erythoromycin, L\IOX: latamoxef, PIPC: IPM/CS: imipenem/cilastatin, MINO: minocycline, (TX: cefotaxime, CLDM: clindamycin, CPFX: ciprolloxacin

1) Jackson F L, Goodman Y E: Transfer of the facultatively anaerobic organism Bacteroides corrodens Eiken to a new genus, Eikenella. Int. J. Syst. Bacteriol. 22: 73 `77, 1972 2) Joshi N, O'bryan T, Appelbaum P C: Pleuropulmonary infections caused by Eikenella corrodens. Rev. Infect. Dis. 13: 1207 `1212, 1991 3) Stoloff A N, Gillies M L: Infections with Eikenella corrodens in a general hospital: a report of 33 cases. Rev. Infect. Dis. 8: 50 `53, 1986 4) Goldstein E J C, Citron D M: Susceptibility of Eikenella corrodens to penicillin, apalcilin, and twelve new cephalosporins. Antimicrob. Agents Chemother. 26: 947 `948, 1984 5) Trallero E P, Arenzana J M J, Eguiluz GC, et al.: -lactamase producing Eikenella corrodens in Ĉ an intra-abdominal abscess. J. Infect. Dis. 153: 379 380, 1986 6) Lacroix J M, Walker C: Characterization of a -lactamase found in Eikenella corrodens Ĉ. Antimicrob. Agents Chemother. 35: 886-891, 1991

VOL.46 NO.7 Pulmonary infection due to Eikenella corrodens: Report of three cases Hiroshi Takahashi1), Toni Kikuchi1), Yutaka Tokue1), Takao Kobayashi1), Satoru Shoji2), Yoshihiro Honda2), Junnichi Chiba3), Shigeru Fujimure, Toshihiro Nukiwa1) and Akira Watanabe1) Department of Respiratory Oncology and Molecular Medicine, Division of Cancer Control, Institute of Development, Aging, and Cancer, Tohoku University, Seiryomachi 4-1, Aoba-ku, Sendai, Miyagi 980-8575, Japan Department of Medicine, Sendai Kosei Hospital Division of Clinical Lavolatory, Sendai Kosei Hospital School of Nursing, Miyagi University Eikenella corrodens is a facultatively anaerobic gram-negative bacillus that is a normal inhabitant of the oral cavity, upper respiratory tract and gastrointestinal tract. Recently, the pathogenic role of this organism has been proven, but pulmonary infection caused by this organism is still uncommon. We report three cases of pulmonary infection, lung abscess, secondary infection of pulmonary bulla with aspergillosis, and empyema, from which E. corrodens was isolated by percutaneous lung aspiration or puncture of pleural effusion. Care should be taken in the diagnosis and treatment of pulmonary infection by E. corrodens since this organism may easily be missed on routine sputum culture, and since this organism exhibits an unusual antimicrobial susceptibility pattern as a pathogen of lung abscess or empyema.

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