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Faculty of Medicine School of Medicine Department of Internal Medicine, Hematology, Respirology, Rheumatology, Infectious Diseases, and Neurology |
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Assistant Professor |
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External Link |
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Related SDGs |
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IWAO Kosho
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Papers 【 display / non-display 】
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Severe Fever with Thrombocytopenia Syndrome Accompanied by Invasive Pulmonary Aspergillosis: An Autopsy Case Reviewed
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 2021.6
Publishing type：Research paper (scientific journal)
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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 2025.1
Language：English Publishing type：Research paper (scientific journal) Publisher：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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Human granulocytic anaplasmosis with rash and rhabdomyolysis: A case report Reviewed
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 2024.12
Language：English Publishing type：Research paper (scientific journal) Publisher：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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Coronavirus disease 2019 in a patient with pulmonary fibrosis and emphysema: An autopsy report. Reviewed
Kudo R, Kawaguchi T, Kimura M, Rikitake Y, Iwao C, Rikitake M, Iwao K, Aizawa A, Kariya Y, Matsuda M, Miyauchi S, Takajo I, Sato Y, Asada Y, Miyazaki T, Umekita K.
Heliyon. 9 ( 11 ) e22221 2023.11
Publishing type：Case report
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Coronavirus disease 2019 in a patient with pulmonary fibrosis and emphysema: An autopsy report Reviewed
Kudo R., Kawaguchi T., Kimura M., Rikitake Y., Iwao C., Rikitake M., Iwao K., Aizawa A., Kariya Y., Matsuda M., Miyauchi S., Takajo I., Sato Y., Asada Y., Miyazaki T., Umekita K.
Heliyon 9 ( 11 ) e22221 2023.11
Language：English Publishing type：Research paper (scientific journal) Publisher：Heliyon
Various diseases (e.g., hypertension and diabetes) are risk factors for the exacerbation of coronavirus 2019 (COVID-19). Patients with chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) tend to develop severe COVID-19. Patients with severe COVID-19 present with acute respiratory distress syndrome (ARDS), and many COVID-19-related ARDS survivors eventually develop fibrosis. However, the appropriate management of patients with COVID-19 and ILD and post-COVID-19 ILD remains unclear. Thus, a better understanding of the pathology that exacerbates COVID-19 in patients with ILD is needed. We report the autopsy results of a patient with COVID-19 and combined pulmonary fibrosis and emphysema, whose lung organization and fibrosis progressed after the acute phase of infection. Histopathological findings suggest that fatal pulmonary fibrosis persists after the negative conversion of SARS-CoV-2. Elucidating the cause of death by autopsy may help determine therapeutic strategies in patients with COVID-19 and ILD. Vaccination and early administration of anti-inflammatory drugs or antifibrotic agents may be crucial for preventing disease progression and fatal lung fibrosis. This report aims to clarify the histopathological features of COVID-19 in patients with ILD via autopsy and discuss treatment strategies.
Presentations 【 display / non-display 】
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抗MDA-5抗体、抗ARS抗体が共陽性となった皮膚筋炎/間質性肺炎の１例
中尾周平、岩尾浩昭、川口 剛、梅北邦彦、宮崎泰可
第336回日本内科学会九州地方会
Event date： 2022.1.29
Presentation type：Oral presentation (general)
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剖検にて侵襲性肺アスペルギルス症の合併が判明した重症熱性血小板減少症候群の一例
岩尾浩昭、川口剛、木村賢俊、岩尾千紘、力武真央、力武雄幹、相澤彩子、仮屋裕美、松田基弘、宮内俊一、髙城一郎、梅北邦彦、宮崎泰可
第91回日本感染症学会西日本地方会学術集会、第64回日本感染症学会中日本地方会学術集会、第69回化学療法学会西日本支部総会 合同学会
Event date： 2021.11.5 - 2021.11.7
Presentation type：Oral presentation (general)
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IPAを合併したSFTSの１例
岩尾浩昭、川口剛
第65回日本医真菌学会総会・学術集会
Event date： 2021.10.29 - 2021.10.30
Presentation type：Oral presentation (general)
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医原性免疫不全関連リンパ増殖性疾患が再燃し、びまん性大細胞型B 細胞リンパ腫を発症した関節リウマチ
佐々木悠、岩尾浩昭、工藤理紗、木村賢俊、力武雄幹、相澤彩子、仮屋裕美、 川口 剛、松田基弘、宮内俊一、髙城一郎、梅北邦彦、宮崎泰可、大栗伸行、 盛口淸香
第67回九州リウマチ学会 2024.3.2
Event date： 2024.3.2 - 2024.3.3
Presentation type：Oral presentation (general)
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ヒトT 細胞白血病ウイルス1 型（HTLV-1）陽性膠原病患者におけるT-SPOT. TB 判定不能の要因に関する検討
木村賢俊、佐々木悠、工藤理紗、力武雄幹、岩尾千紘、岩尾浩昭、力武真央、相澤彩子、仮屋裕美、川口 剛、松田基弘、宮内俊一、梅北邦彦
第67回九州リウマチ学会 2024.3.2
Event date： 2024.3.2 - 2024.3.3
Presentation type：Oral presentation (general)