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Phlegmonous gastritis developed during chemotherapy for acute lymphocytic leukemia : A case report

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Title: Phlegmonous gastritis developed during chemotherapy for acute lymphocytic leukemia : A case report
Authors: Saito, Makoto Browse this author
Morioka, Masanobu Browse this author
Izumiyama, Koh Browse this author
Mori, Akio Browse this author
Ogasawara, Reiki Browse this author
Kondo, Takeshi Browse this author
Miyajima, Toru Browse this author
Yokoyama, Emi Browse this author
Tanikawa, Satoshi Browse this author →KAKEN DB
Keywords: Phlegmonous gastritis
Bacillus cereus
Case report
Issue Date: 6-Aug-2021
Publisher: Baishideng Publishing Group
Journal Title: World Journal of Clinical Cases
Volume: 9
Issue: 22
Start Page: 6493
End Page: 6500
Publisher DOI: 10.12998/wjcc.v9.i22.6493
Abstract: BACKGROUND Phlegmonous gastritis (PG) is a rare bacterial infectious disease characterized by neutrophil-based purulent inflammation of the gastric wall. The most representative causative bacterium is Streptococcus pyogenes, followed by Staphylococcus, Pneumococcus and Enterococcus. Hepatic portal venous gas (HPVG) is considered a potentially fatal condition and is rarely associated with PG. CASE SUMMARY The white blood cell count of a 70-year-old woman with acute lymphocytic leukemia in complete remission dropped to 100/mu L after consolidation chemotherapy. Her vital signs were consistent with septic shock. Venous blood culture revealed the presence of Bacillus cereus. Abdominal computed tomography (CT) and esophagogastroduodenoscopy (EGD) showed marked thickening of the gastric wall. As with the other findings, CT was suggestive of HPVG, and EGD showed pseudomembrane-like tissue covering the superficial mucosa. Histopathological examination of gastric biopsy specimens showed mostly necrotic tissue with lymphocytes rather than neutrophils. Culture of gastric specimens revealed the presence of Bacillus cereus. We finally diagnosed this case as PG with Bacillus cereus-induced sepsis and HPVG. This patient recovered successfully with conservative treatment, chiefly by using carbapenem antibiotics. CONCLUSION The histopathological finding of this gastric biopsy specimen should be called "neutropenic necrotizing gastritis".
Type: article
Appears in Collections:化学反応創成研究拠点:ICReDD (Institute for Chemical Reaction Design and Discovery : ICReDD) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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