Severe Pulmonary Suppuration with Infection-Induced Systemic Inflammatory Response Syndrome following Tongue Cancer Surgery in a Patient Undergoing Tocilizumab Therapy for Rheumatoid Arthritis

Kenji Yamagata; Nobutake Shimojo; Hiroyuki Ito; Junya Ijima; Shogo Hasegawa; Toru Yanagawa; Taro Mizutani; Hiroki Bukawa

doi:10.1155/2014/649086

Case Reports in Dentistry (Jan 2014)

Severe Pulmonary Suppuration with Infection-Induced Systemic Inflammatory Response Syndrome following Tongue Cancer Surgery in a Patient Undergoing Tocilizumab Therapy for Rheumatoid Arthritis

Kenji Yamagata,
Nobutake Shimojo,
Hiroyuki Ito,
Junya Ijima,
Shogo Hasegawa,
Toru Yanagawa,
Taro Mizutani,
Hiroki Bukawa

Affiliations

Kenji Yamagata: Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
Nobutake Shimojo: Department of Emergency and Critical Care, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
Hiroyuki Ito: Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
Junya Ijima: Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
Shogo Hasegawa: Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
Toru Yanagawa: Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
Taro Mizutani: Department of Emergency and Critical Care, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
Hiroki Bukawa: Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan

DOI: https://doi.org/10.1155/2014/649086
Journal volume & issue: Vol. 2014

Abstract

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A 65-year-old woman with rheumatoid arthritis treated by tocilizumab (TCZ) presented with tongue squamous cell carcinoma. While surgery was performed without any complications the aspiration pneumonia rapidly worsened by postoperative day 2 and severe pulmonary suppuration in the right lung field with infection-induced systemic inflammatory response syndrome (SIRS) was diagnosed. Antibiotic and respirator treatment improved her condition. The anti-inflammatory effect of TCZ may mask the symptoms and signs of severe infection with SIRS.

Published in Case Reports in Dentistry

ISSN: 2090-6447 (Print); 2090-6455 (Online)
Publisher: Wiley
Country of publisher: United Kingdom
LCC subjects: Medicine: Dentistry
Website: https://onlinelibrary.wiley.com/journal/2415

About the journal