Internal medicine (Tokyo, Japan) · 2020
Small Intestinal Bacterial Overgrowth Diagnosed by a Breath Test and Improved by Rifaximin in a Patient with Hepatic Encephalopathy and Alcoholic Liver Cirrhosis.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Sakamaki Akira, Yokoyama Kunihiko, Yamazaki Fusako, Kamimura Hiroteru, Kamimura Kenya, Takamura Masaaki, Yokoyama Junji, Terai Shuji
Аннотация
A 66-year-old Japanese man was admitted to our hospital with grade 2 hepatic encephalopathy (HE). Abdominal computed tomography and laboratory examinations revealed decompensated liver cirrhosis. Intravenous administration of branched-chain amino acids immediately ameliorated the HE, and lactulose was initiated. However, a breath test revealed small intestinal bacterial overgrowth (SIBO); therefore, rifaximin was additionally initiated. The breath test was repeated after discharge, when no evidence of SIBO or overt HE was identified. This case suggested that a breath test is effective for the identification of SIBO and that the administration of a poorly absorbed antibiotic should be considered in SIBO-positive HE patients taking lactulose.