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医学部 附属病院 膠原病・感染症内科 |
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Kawaguchi T., Kitamura A., Kimura M., Rikitake Y., Iwao C., Iwao K., Sumiyoshi M., Kariya Y., Matsuda M., Umekita K., Takajo I., Moriguchi-Goto S., Yamashita A., Matsumoto K., Miyazaki T.
Journal of Infection and Chemotherapy 31 ( 1 ) 102534 2025年1月
担当区分：筆頭著者 記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Journal of Infection and Chemotherapy
Treating disseminated cryptococcosis in people with human immunodeficiency virus (HIV) is challenging due to the limited availability of effective antifungals. Although isavuconazole has antifungal activity against Cryptococcus neoformans, clinical evidence is sparse because this new drug has not been approved for the treatment of cryptococcosis in the US or Europe. Here, we report a case of HIV-associated cryptococcal meningitis that relapsed during maintenance therapy with fluconazole. A Japanese man in his 20s was diagnosed with HIV-1 infection and cryptococcal meningitis. The patient was intolerant to flucytosine and was treated with liposomal amphotericin B monotherapy for 2 weeks as induction therapy, followed by fluconazole (400 mg/day) for 3 months as consolidation therapy. Four months after starting maintenance therapy with fluconazole (200 mg/day), the patient presented with fever and cough, leading to readmission to our hospital. Biopsies of a nodule in the left lung and a left cervical lymph node led to the diagnosis of disseminated cryptococcosis (pulmonary cryptococcosis and cryptococcal lymphadenitis). Although a combination of fluconazole and liposomal amphotericin B was ineffective, the patient was successfully treated with an induction therapy combining isavuconazole and liposomal amphotericin B, followed by a maintenance therapy with isavuconazole. The patient received isavuconazole orally except for loading doses, achieving stable blood concentration levels. Moreover, we observed that blood levels of amphotericin B increased gradually with repeated administration. Therefore, isavuconazole may have a potential role in the treatment of cryptococcosis, and clinical trials involving larger numbers of cases are needed to confirm its efficacy and safety.
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Kawaguchi T., Matsuda M., Umekita K., Miyazaki T.
Respirology Case Reports 12 ( 7 ) e01428 2024年7月
担当区分：筆頭著者 記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Respirology Case Reports
Nintedanib has been demonstrated to inhibit the rate of forced vital capacity decline in patients with progressive fibrosing interstitial lung diseases (PF-ILD) at a dose of 200 or 300 mg/day in the INBUILD trial. Although concomitant use of nintedanib with P-glycoprotein inhibitors reportedly increases the plasma concentrations of the former, tacrolimus, a P-glycoprotein inhibitor, is often used to treat connective tissue diseases-related interstitial lung diseases. The optimal dose of nintedanib in combination with tacrolimus for the treatment of PF-ILD with connective tissue disease is unknown. We herein present two patients with PF-ILD with anti-aminoacyl-tRNA synthetase antibody-positive dermatomyositis who were successfully treated with low-dose nintedanib (<200 mg/day) in combination with tacrolimus.
DOI： 10.1002/rcr2.1428
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Human granulocytic anaplasmosis with rash and rhabdomyolysis: A case report 査読あり
Kawaguchi T., Rikitake Y., Rikitake M., Kimura M., Iwao C., Iwao K., Aizawa A., Sumiyoshi M., Kariya Y., Matsuda M., Miyauchi S., Umekita K., Takajo I., Ohashi N., Miyazaki T.
Journal of Infection and Chemotherapy 30 ( 12 ) 1309 - 1314 2024年
担当区分：筆頭著者 記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Journal of Infection and Chemotherapy
Human granulocytic anaplasmosis (HGA) is a tick-borne infection caused by Anaplasma phagocytophilum. Only seven cases of HGA have been reported in Japan to date. We report the case of a 61-year-old female farmer who developed HGA with rash and rhabdomyolysis. The patient had fever and erythema covering the entire body, including the palms. An induration with an eschar was observed on the right leg, indicating that the patient had been bitten by a tick. Elevated serum creatinine and creatinine kinase levels and hematuria indicated rhabdomyolysis. We suspected Japanese spotted fever, a tick-borne illness caused by Rickettsia Japonica, and administered minocycline and ciprofloxacin for a week. Transient neutropenia and thrombocytopenia were observed, but the symptoms improved. Polymerase chain reaction (PCR) and antibody tests for R. japonica and Orientia tsutsugamushi, which causes scrub typhus, were both negative. The PCR test for severe fever with thrombocytopenia syndrome virus was also negative. Antibodies against A. phagocytophilum–related proteins were detected by western blotting, indicating seroconversion of IgG with paired serum samples, and the patient was diagnosed with HGA. HGA should be suspected in acute febrile patients with a history of outdoor activity and cytopenia, with or without a rash. A testing system and the accumulation of cases in Japan are necessary for the early diagnosis and appropriate treatment of HGA.
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Neuropsychiatric Systemic Lupus Erythematosus with Cerebral Vasculitis and Lupus Nephritis Successfully Treated with High-dose Glucocorticoids and Mycophenolate Mofetil: A Case Report. 査読あり
Tanaka S, Kawaguchi T, Kudo R, Kimura M, Rikitake Y, Iwao C, Rikitake M, Iwao K, Aizawa A, Kariya Y, Matsuda M, Miyauchi S, Takajo I, Umekita K.
Intern Med 2022年3月
掲載種別：研究論文（学術雑誌）
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Severe Fever with Thrombocytopenia Syndrome Accompanied by Invasive Pulmonary Aspergillosis: An Autopsy Case 査読あり
Iwao K, Kawaguchi T, Kimura M, Iwao C, Rikitake M, Aizawa A, Kariya Y, Matsuda M, Miyauchi S, Takajo I, Kiwaki T, Fukushima T, Kataoka H, Suzuki T, Okayama A, Umekita K
Viruses 13 ( 6 ) 1086 2021年6月
掲載種別：研究論文（学術雑誌）
MISC 【 表示 ／ 非表示 】
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【重症熱性血小板減少症候群：SFTS】SFTSの臨床と課題 査読あり
川口剛
医療と検査機器・試薬 47 ( 6 ) 493 - 497 2024年12月
担当区分：筆頭著者 記述言語：日本語 掲載種別：記事・総説・解説・論説等（学術雑誌）
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特集 新型コロナ最前線 ワクチンと治療-今を知り，これからを考える 新型コロナ治療の最前線-② 新規コロナ治療薬. 招待あり
川口剛，宮崎泰可
感染と抗菌薬 24 ( 4 ) 238 - 241 2021年12月
担当区分：筆頭著者 記述言語：日本語 掲載種別：記事・総説・解説・論説等（商業誌、新聞、ウェブメディア）
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宮崎県における日本紅斑熱と重症熱性血小板減少症候群の臨床的特徴の比較
宮崎大学医学部附属病院膠原病感染症内科 川口剛
病原微生物検出情報 Infectious Agents Surveillance Report 2020年8月
掲載種別：記事・総説・解説・論説等（商業誌、新聞、ウェブメディア）
講演・口頭発表等 【 表示 ／ 非表示 】
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PF-ILDにおける抗線維化薬の導入と管理-当科経験例-
川口剛
PF-ILD joint Conference
開催年月日： 2022年9月13日
会議種別：公開講演，セミナー，チュートリアル，講習，講義等
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重症熱性血小板減少症候群に侵襲性肺アスペルギルス症を合併した6症例の検討
川口剛、山中篤志、原誠一郎、山口哲朗、木村賢俊、力武雄幹、岩尾千紘、力武真央、岩尾浩昭、相澤彩子、仮屋裕美、松田基弘、宮内俊一、梅北邦、高城一郎彦、宮崎泰可
第4回SFTS研究会学術集会
開催年月日： 2022年9月10日
会議種別：口頭発表（一般）
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CTD-ILDへの抗線維化薬の位置づけ-当科経験例-
川口剛
CTD-ILD Meet The Expert in 南九州
開催年月日： 2022年8月20日
会議種別：公開講演，セミナー，チュートリアル，講習，講義等
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膠原病関連間質性肺炎に合併した浸潤性粘液性肺腺癌の1例
川口剛、重草貴文、小田康晴、坪内拡伸、宮内俊一、松元信弘
第45回日本呼吸器内視鏡学会学術集会
開催年月日： 2022年5月26日 - 2022年5月27日
会議種別：口頭発表（一般）
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膠原病に伴う間質性肺疾患(CTD-ILD)〜早期診断と長期のフォローアップ〜
川口剛
南那珂医師会生涯教育医学会
開催年月日： 2022年5月17日
会議種別：公開講演，セミナー，チュートリアル，講習，講義等
科研費（文科省・学振・厚労省）獲得実績 【 表示 ／ 非表示 】
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SFTSウイルス感染は宿主の好中球機能を低下させ，真菌症合併のリスクとなるか？
研究課題/領域番号：23K15372 2023年04月 - 2026年03月
独立行政法人日本学術振興会 科学研究費基金 若手研究
担当区分：研究代表者