Article in Japanese

A case of intractable sepsis caused by Acinetobacter lwoffii in a girl with an eating disorder

Miori YUASA, Motoko YASUTOMI, Hisako HAYASHI, Toshihide YOSHIKAWA, Akiko KAWAKITA, Akio NAKAI, Yusei OHSHIMA

We report here a nine year old girl with eating disorder who developed sepsis caused by Acinetobacter lwoffii during intravenous nutrition via peripheral blood vessels. The strain of Acinetobacter lwoffii isolated from blood cultures was susceptible to third and fourth generation cephalosporins, carbapenems, and tetracyclines. Her clinical symptoms were temporarily ameliorated by treatment with cefozopran, but subsequently flared up again. The systemic inflammatory responses were finally cured by a combination therapy including vancomycin, ceftazidime and minocycline. Since intravenous catheters retained in peripheral blood vessels were considered to be the route and focus of the Acinetobacter infection, intravenous catheters were frequently replaced with shortened indwelling periods and parenteral nutrition was changed to nasal feeding. After these changes, the Acinetobacter infection did not recur. In this case, hypocomplementemia associated with malnutrition due to eating disorder may have made the infection prolonged and refractory to treatment.

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Department of Pediatrics, Faculty of Medicine, Fukui University

Key words
Received	June 20, 2011
Accepted	December 14, 2011

24 (2)：138─142,2012