腺筋症に伴う子宮内膜炎に起因する侵襲的非型別性H. influenzae感染症

Invasive non-typeable Haemophilus influenzae infection due to endometritis associated with adenomyosis.

• Yoshito Nishimura
• Hideharu Hagiya
• Kaoru Kawano
• Yuya Yokota
• Kosuke Oka
• Koji Iio
• Kou Hasegawa
• Mikako Obika
• Tomoko Haruma
• Sawako Ono
• Hisashi Masuyama
• Fumio Otsuka

抄録

背景:

Haemophilus influenzae b 型ワクチンの広範な投与により、非型別 H. influenzae (NTHi) が優勢になっている。しかし、婦人科疾患に基づく侵襲性NTHi感染症の発生はまだまれである。

BACKGROUND: The widespread administration of the Haemophilus influenzae type b vaccine has led to the predominance of non-typable H. influenzae (NTHi). However, the occurrence of invasive NTHi infection based on gynecologic diseases is still rare.

ケースプレゼンテーション:

腺筋腫既往歴のある51歳の日本人女性が発熱を呈した．血液培養と膣分泌物培養でNTHiが陽性であったため，Gaシンチグラフィで子宮内に高値を示し，侵襲性NTHi感染症と診断された．抗生物質投与に加え，子宮全摘術を行った．病理検査の結果，腺筋症の中に微細な膿瘍が認められた．

CASE PRESENTATION: A 51-year-old Japanese woman with a history of adenomyoma presented with fever. Blood cultures and a vaginal discharge culture were positive with NTHi. With the high uptake in the uterus with Ga scintigraphy, she was diagnosed with invasive NTHi infection. In addition to antibiotic administrations, a total hysterectomy was performed. The pathological analysis found microabscess formations in adenomyosis.

結論:

腺筋症における微小膿瘍形成に起因するNTHi菌血症はまれであるが，本症例は子宮を感染源として考慮する必要性を強調するものである．

CONCLUSIONS: Although NTHi bacteremia consequent to a microabscess in adenomyosis is rare, this case emphasizes the need to consider the uterus as a potential source of infection in patients with underlying gynecological diseases, including an invasive NTHi infection with no known primary focus.