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Brain and Nerve No to Shinkei Volume 55, Issue 3 （March 2003）

Brain and Nerve 脳と神経 55巻3号（2003年3月発行）

Japanese English

症例報告

重症髄膜炎，多臓器不全で発症し救命しえたOPSI（overwhelming postsplenectomy infection）の1例 A Survival Case of Fluminant Meningitis and Multiple Organ Failure as Overwhelming Postsplenectomy Infection（OPSI） Syndrome 高沢弘樹 ¹ , 鬼塚圭一郎 ¹ , 山下巌 ² , 須永中 ² , 遠藤俊郎 ³ Hiroki Takazawa ¹ , Keiichiro Onizuka ¹ , Iwao Yamashita ² , Ataru Sunaga ² , Shunro Endo ³ ¹東名厚木病院脳神経外科 ²東名厚木病院救急部 ³富山医科薬科大学医学部脳神経外科 ¹Department of Neurosurgery and Critical Care Medicine, Tomeiatsugi Hospital ²Department of Emergency and Critical Care Medicine, Tomeiatsugi Hospital ³Department of Neurosurgery, Toyama Medical and Pharmaceutical University キーワード： overwhelming postsplenectomy infection（OPSI） , meningitis , multiple organ failure（MOF） , disseminated intravascular coagulation（DIC） Keyword: overwhelming postsplenectomy infection（OPSI） , meningitis , multiple organ failure（MOF） , disseminated intravascular coagulation（DIC） pp.269-272

発行日 2003年3月1日 Published Date 2003/3/1

DOI https://doi.org/10.11477/mf.1406100461

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Abstract 文献概要
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要旨　39歳男性の摘脾患者が重症髄膜炎にて発症し，多臓器不全，播種性血管内凝固（DIC）を併発した。早期の化学療法にて神経脱落症状を残さず退院した。摘脾患者は，長期経過中に重症感染症に罹患しやすく，OPSI症候群として注目されている。ワクチン接種や抗生剤携帯および患者教育が重要である。

A 39-year-old man,who had splenectomy following abdominal trauma 30 years previously, admitted to our hospital with high fever, headache and convulsion on January 8, 2002. Examination of cerebrospinal fluid（CSF） showed pleocytosis up to 10,000cells／mm3 with polymorphonuclear cells dominant and elevated protein to 330mg／dl and reduction of glucose to 15mg／dl. Streptococcus pneumoniae was detected at the culture of CSF and blood. We diagnosed him as having pneumococcal meningitis as overwhelming postsplenectomy infection（OPSI） syndrome. After administration of carbapenem antibiotics, methylprednisolone（1,000mg） and immunoglobulin, he survived without any complications. Splenectomized patients are likely to suffer from severe infections, such as sepsis and meningitis, which is called OPSI syndrome. The course is rapid, the clinical symptoms are serious, and the prognosis is very poor. It is important for splenectomized patients to receive the vaccine, antibiotic prophylaxis and seek medical attention at the earliest sign of minor infection.