MERS associated with bacterial translocation in a pediatric patient with congenital portal vein hypoplasia: A case report
Identifieur interne : 000C65 ( Pmc/Curation ); précédent : 000C64; suivant : 000C66MERS associated with bacterial translocation in a pediatric patient with congenital portal vein hypoplasia: A case report
Auteurs : George Imataka [Japon] ; Takeshi Yamaguchi [Japon] ; Junpei Ishii [Japon] ; Kei Ogino [Japon] ; Kentaro Okamoto [Japon] ; Takashi Tsuchioka [Japon] ; Shigemi Yoshihara [Japon]Source :
- Experimental and Therapeutic Medicine [ 1792-0981 ] ; 2018.
Abstract
A case of mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) in a female child who developed bacterial translocation from a congenital portal vein hypoplasia is reported. The patient was diagnosed as having portal hypertension after examinations and laboratory results showing splenomegaly and thrombocytopenia at the age of 1 year. The patient required three endoscopic variceal ligation (EVL) surgeries before the age of 9 due to development of multiple esophageal varices. After the second and third EVL procedures, she developed septicemia, possibly due to bacterial translocation associated with the administration of general anesthesia. The day after the third EVL, the patient presented with high fever and neurological disturbances (altered consciousness). Magnetic resonance imaging detected abnormal intensities in the corpus callosum ampulla and cerebral white matter, which suggested a diagnosis of MERS type 2. Considering this clinical course, the possible association between bacterial translocation and MERS in a patient with congenital portal vein hypoplasia and portal hypertension is discussed.
Url:
DOI: 10.3892/etm.2018.6532
PubMed: 30214504
PubMed Central: 6125833
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Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Pediatrics, Dokkyo Medical University, Shimotsuga, Tochigi 321-0293</wicri:regionArea></affiliation></author><author><name sortKey="Yamaguchi, Takeshi" sort="Yamaguchi, Takeshi" uniqKey="Yamaguchi T" first="Takeshi" last="Yamaguchi">Takeshi Yamaguchi</name><affiliation wicri:level="1"><nlm:aff id="af2-etm-0-0-6532">Department of First Surgery, Dokkyo Medical University, Shimotsuga, Tochigi 321-0293, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of First Surgery, Dokkyo Medical University, Shimotsuga, Tochigi 321-0293</wicri:regionArea></affiliation></author><author><name sortKey="Ishii, Junpei" sort="Ishii, Junpei" uniqKey="Ishii J" first="Junpei" last="Ishii">Junpei Ishii</name><affiliation wicri:level="1"><nlm:aff id="af1-etm-0-0-6532">Department of Pediatrics, Dokkyo Medical University, Shimotsuga, Tochigi 321-0293, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Pediatrics, Dokkyo Medical University, Shimotsuga, Tochigi 321-0293</wicri:regionArea></affiliation></author><author><name sortKey="Ogino, Kei" sort="Ogino, Kei" uniqKey="Ogino K" first="Kei" last="Ogino">Kei Ogino</name><affiliation wicri:level="1"><nlm:aff id="af2-etm-0-0-6532">Department of First Surgery, Dokkyo Medical University, Shimotsuga, Tochigi 321-0293, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of First Surgery, Dokkyo Medical University, Shimotsuga, Tochigi 321-0293</wicri:regionArea></affiliation></author><author><name sortKey="Okamoto, Kentaro" sort="Okamoto, Kentaro" uniqKey="Okamoto K" first="Kentaro" last="Okamoto">Kentaro Okamoto</name><affiliation wicri:level="1"><nlm:aff id="af2-etm-0-0-6532">Department of First Surgery, Dokkyo Medical University, Shimotsuga, Tochigi 321-0293, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of First Surgery, Dokkyo Medical University, Shimotsuga, Tochigi 321-0293</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3-etm-0-0-6532">Department of Pediatric Surgery, Tokyo Medical and Dental University, Tokyo 113-8510, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Pediatric Surgery, Tokyo Medical and Dental University, Tokyo 113-8510</wicri:regionArea></affiliation></author><author><name sortKey="Tsuchioka, Takashi" sort="Tsuchioka, Takashi" uniqKey="Tsuchioka T" first="Takashi" last="Tsuchioka">Takashi Tsuchioka</name><affiliation wicri:level="1"><nlm:aff id="af2-etm-0-0-6532">Department of First Surgery, Dokkyo Medical University, Shimotsuga, Tochigi 321-0293, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of First Surgery, Dokkyo Medical University, Shimotsuga, Tochigi 321-0293</wicri:regionArea></affiliation></author><author><name sortKey="Yoshihara, Shigemi" sort="Yoshihara, Shigemi" uniqKey="Yoshihara S" first="Shigemi" last="Yoshihara">Shigemi Yoshihara</name><affiliation wicri:level="1"><nlm:aff id="af1-etm-0-0-6532">Department of Pediatrics, Dokkyo Medical University, Shimotsuga, Tochigi 321-0293, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Pediatrics, Dokkyo Medical University, Shimotsuga, Tochigi 321-0293</wicri:regionArea></affiliation></author></analytic><series><title level="j">Experimental and Therapeutic Medicine</title><idno type="ISSN">1792-0981</idno><idno type="eISSN">1792-1015</idno><imprint><date when="2018">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>A case of mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) in a female child who developed bacterial translocation from a congenital portal vein hypoplasia is reported. The patient was diagnosed as having portal hypertension after examinations and laboratory results showing splenomegaly and thrombocytopenia at the age of 1 year. The patient required three endoscopic variceal ligation (EVL) surgeries before the age of 9 due to development of multiple esophageal varices. After the second and third EVL procedures, she developed septicemia, possibly due to bacterial translocation associated with the administration of general anesthesia. The day after the third EVL, the patient presented with high fever and neurological disturbances (altered consciousness). Magnetic resonance imaging detected abnormal intensities in the corpus callosum ampulla and cerebral white matter, which suggested a diagnosis of MERS type 2. Considering this clinical course, the possible association between bacterial translocation and MERS in a patient with congenital portal vein hypoplasia and portal hypertension is discussed.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Tada, H" uniqKey="Tada H">H Tada</name></author><author><name sortKey="Takanashi, J" uniqKey="Takanashi J">J Takanashi</name></author><author><name sortKey="Barkovich, Aj" uniqKey="Barkovich A">AJ Barkovich</name></author><author><name sortKey="Oba, H" uniqKey="Oba H">H Oba</name></author><author><name sortKey="Maeda, M" uniqKey="Maeda M">M Maeda</name></author><author><name sortKey="Tsukahara, H" uniqKey="Tsukahara H">H Tsukahara</name></author><author><name sortKey="Suzuki, M" uniqKey="Suzuki M">M Suzuki</name></author><author><name sortKey="Yamamoto, T" uniqKey="Yamamoto T">T Yamamoto</name></author><author><name sortKey="Shimono, T" uniqKey="Shimono T">T Shimono</name></author><author><name 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Exp Ther Med</journal-id><journal-id journal-id-type="iso-abbrev">Exp Ther Med</journal-id><journal-id journal-id-type="publisher-id">ETM</journal-id><journal-title-group><journal-title>Experimental and Therapeutic Medicine</journal-title></journal-title-group><issn pub-type="ppub">1792-0981</issn><issn pub-type="epub">1792-1015</issn><publisher><publisher-name>D.A. Spandidos</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">30214504</article-id><article-id pub-id-type="pmc">6125833</article-id><article-id pub-id-type="doi">10.3892/etm.2018.6532</article-id><article-id pub-id-type="publisher-id">ETM-0-0-6532</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group></article-categories><title-group><article-title>MERS associated with bacterial translocation in a pediatric patient with congenital portal vein hypoplasia: A case report</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Imataka</surname><given-names>George</given-names></name><xref ref-type="aff" rid="af1-etm-0-0-6532">1</xref><xref rid="c1-etm-0-0-6532" ref-type="corresp"></xref></contrib><contrib contrib-type="author"><name><surname>Yamaguchi</surname><given-names>Takeshi</given-names></name><xref ref-type="aff" rid="af2-etm-0-0-6532">2</xref></contrib><contrib contrib-type="author"><name><surname>Ishii</surname><given-names>Junpei</given-names></name><xref ref-type="aff" rid="af1-etm-0-0-6532">1</xref></contrib><contrib contrib-type="author"><name><surname>Ogino</surname><given-names>Kei</given-names></name><xref ref-type="aff" rid="af2-etm-0-0-6532">2</xref></contrib><contrib contrib-type="author"><name><surname>Okamoto</surname><given-names>Kentaro</given-names></name><xref ref-type="aff" rid="af2-etm-0-0-6532">2</xref><xref ref-type="aff" rid="af3-etm-0-0-6532">3</xref></contrib><contrib contrib-type="author"><name><surname>Tsuchioka</surname><given-names>Takashi</given-names></name><xref ref-type="aff" rid="af2-etm-0-0-6532">2</xref></contrib><contrib contrib-type="author"><name><surname>Yoshihara</surname><given-names>Shigemi</given-names></name><xref ref-type="aff" rid="af1-etm-0-0-6532">1</xref></contrib></contrib-group><aff id="af1-etm-0-0-6532"><label>1</label>Department of Pediatrics, Dokkyo Medical University, Shimotsuga, Tochigi 321-0293, Japan</aff><aff id="af2-etm-0-0-6532"><label>2</label>Department of First Surgery, Dokkyo Medical University, Shimotsuga, Tochigi 321-0293, Japan</aff><aff id="af3-etm-0-0-6532"><label>3</label>Department of Pediatric Surgery, Tokyo Medical and Dental University, Tokyo 113-8510, Japan</aff><author-notes><corresp id="c1-etm-0-0-6532"><italic>Correspondence to</italic>: Dr George Imataka, Department of Pediatrics, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan, E-mail: <email>geo@dokkyomed.ac.jp</email></corresp></author-notes><pub-date pub-type="ppub"><month>10</month><year>2018</year></pub-date><pub-date pub-type="epub"><day>27</day><month>7</month><year>2018</year></pub-date><pub-date pub-type="pmc-release"><day>27</day><month>7</month><year>2018</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on the
<volume>16</volume><issue>4</issue><fpage>2831</fpage><lpage>2834</lpage><history><date date-type="received"><day>06</day><month>10</month><year>2017</year></date><date date-type="accepted"><day>08</day><month>12</month><year>2017</year></date></history><permissions><copyright-statement>Copyright: © Imataka et al.</copyright-statement><copyright-year>2018</copyright-year><license license-type="open-access"><license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by-nc-nd/4.0/">Creative Commons Attribution-NonCommercial-NoDerivs License</ext-link>, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.</license-p></license></permissions><abstract><p>A case of mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) in a female child who developed bacterial translocation from a congenital portal vein hypoplasia is reported. The patient was diagnosed as having portal hypertension after examinations and laboratory results showing splenomegaly and thrombocytopenia at the age of 1 year. The patient required three endoscopic variceal ligation (EVL) surgeries before the age of 9 due to development of multiple esophageal varices. After the second and third EVL procedures, she developed septicemia, possibly due to bacterial translocation associated with the administration of general anesthesia. The day after the third EVL, the patient presented with high fever and neurological disturbances (altered consciousness). Magnetic resonance imaging detected abnormal intensities in the corpus callosum ampulla and cerebral white matter, which suggested a diagnosis of MERS type 2. Considering this clinical course, the possible association between bacterial translocation and MERS in a patient with congenital portal vein hypoplasia and portal hypertension is discussed.</p></abstract><kwd-group><kwd>mild encephalitis/encephalopathy with a reversible splenial lesion</kwd><kwd>bacterial translocation</kwd><kwd>endoscopic variceal ligation</kwd><kwd>congenital portal vein hypoplasia</kwd><kwd>portal hypertension</kwd></kwd-group></article-meta></front><floats-group><fig id="f1-etm-0-0-6532" orientation="portrait" position="float"><label>Figure 1.</label><caption><p>Brain MRI upon hospital admission. Top panels: (DWI) of abnormal signal intensities from MRI were mainly in the corpus callosum and in both sides of the white matter before treatment. Lower panels: DWI signal intensities on MRI improved two days after treatment. DWI, diffusion weighted image; MRI, magnetic resonance imaging.</p></caption><graphic xlink:href="etm-16-04-2831-g00"></graphic></fig><fig id="f2-etm-0-0-6532" orientation="portrait" position="float"><label>Figure 2.</label><caption><p>Brain magnetic resonance imaging after MERS resolution. Micro-bleeding of small vessels was recognized following the fat suppression method of short T1 weighted inversion recovery images after treatment. MERS: mild encephalitis/encephalopathy with a reversible splenial lesion.</p></caption><graphic xlink:href="etm-16-04-2831-g01"></graphic></fig></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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