@article{oai:shiga-med.repo.nii.ac.jp:00004470,
 author = {KARAKIDA, Rie and KOSHINUMA, Shinya and MURAI, Takato and NARUKAMI, Iori and OKAMURA, Takeshi and YAMAMOTO, Takahiro and YAMAMOTO, Gaku and 唐木田, りえ and 越沼, 伸也 and 村井, 崇人 and 鳴神, 伊織 and 岡村, 武志 and 山元, 貴弘 and 山本, 学},
 issue = {1},
 journal = {滋賀医科大学雑誌},
 month = {Mar},
 note = {顎放線菌症の治療中に播種性血管内凝固症候群(Disseminated Intravascular Coagulation：DIC)および上部消化管出血を併発した症例を報告する. 患者は89歳女性. 2021年10月中旬に左側下顎8部歯肉の排膿および左側頬部腫脹のため当科を紹介受診した. 初診時, 著しい開口障害と左側頬部腫脹および疼痛を認め, 左側下顎8番智歯周囲炎および左側頬部蜂窩織炎と診断した. その後, 切開排膿時に採取した膿の細菌検査にてActinomyces meyeriおよびその菌塊が検出されたため, 顎放線菌症と最終診断した. 処置および経過：初診日に入院し, 入院3日目の血液検査にて血小板数の低値およびFDP, アンチトロンビン, TATの高値を認め, 日本血栓止血学会の定める診断基準より感染症型DICと診断した. 入院4日目に口腔外切開排膿術およびメロペネム投与を開始し，入院11日目に感染症型DICからの離脱を認めた. また入院9日目より顎放線菌症に対しスルバシリン3.0 g /日を15日間静脈内投与し左側頬部腫脹の軽減を認めていたが, 入院18日目に吐血と著しい貧血を認め内視鏡検査にて上部消化管出血と診断しクリッピングおよび焼灼止血を行い止血した. その後全身状態および開口障害と左側頬部腫脹の改善を認めたため入院43日目に軽快退院となった., Actinomycosis of the jaw, which is slightly rare disease at the oral and maxillofacial region, progress to the disseminated intravascular coagulation irregularly. Here, we report a rare case of the actinomycosis of the jaw complicated with disseminated intravascular coagulation (DIC) accompanied by intestinal hemorrhage. The patient was an 89-years-old woman who had the swelling of the left buccal region and lower-left mandibular gingiva. Above the findings of imaging and bacteriological examination, diagnosis of the actinomycosis of the jaw was made. During antibacterial treatment, her general condition deteriorated rapidly, and the blood test results met the diagnostic criteria of DIC. Moreover, the hematemesis and significant anemia developed during the intensive care, and endoscopy findings showed the hemorrhage at the greater curvature of stomach. Watchful general care should be needed during treatment actinomycosis of the jaw, in particular, affect the elderly.},
 pages = {75--79},
 title = {顎放線菌症の治療中にDICおよび上部消化管出血を併発した一例},
 volume = {36},
 year = {2023}
}